Individual
J DOUGLAS STAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
320 A AVE, LAKE OSWEGO, OR 97034-3056
(503) 636-2762
(503) 636-4502
Mailing address
320 A AVE, LAKE OSWEGO, OR 97034-3056
(503) 636-2762
(503) 636-4502
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1088T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164525
—
OR
Enumeration date
05/10/2006
Last updated
06/29/2009
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