Individual
MS. CAROL ROGERS STAMPFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP
Contact information
Practice address
4212 NE BROADWAY ST, PORTLAND, OR 97213-1422
(503) 382-7709
(503) 382-7706
Mailing address
4212 NE BROADWAY ST, PORTLAND, OR 97213-1422
(503) 382-7709
(503) 382-7706
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
200550012NP
OR
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
200550012NP PMHNP PP
OR
163WP2201X
Ambulatory Care Registered Nurse
83037966FNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006205797
—
OR
Enumeration date
11/02/2006
Last updated
09/29/2015
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