Individual
STACEY BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
6396 SW MCVEY AVE, REDMOND, OR 97756-9069
(541) 316-0641
Mailing address
1317 SW 27TH ST, REDMOND, OR 97756-5101
(503) 758-6740
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
056.007974
IL
225XP0200X
Pediatric Occupational Therapist
Primary
213691
OR
Other
Enumeration date
09/24/2009
Last updated
04/15/2026
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