Individual
STACEY MARIE MERZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 418-5505
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 418-5505
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA01155
OR
363AM0700X
Medical Physician Assistant
Primary
PA01155
OR
Other
Enumeration date
10/16/2006
Last updated
01/04/2022
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