Individual
STACY PICKEREL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 780-9284
Mailing address
PO BOX 941, SANDY, OR 97055-0941
(503) 780-9284
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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