Individual
DR. STACI JOANNA ESKESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5330 NE GLISAN ST, SUITE 100, PORTLAND, OR 97213-3069
(503) 215-9700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00045696
WA
207Q00000X
Family Medicine Physician
Primary
MD126257
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500609393
—
OR
05
—
8455768
—
WA
01
—
P01477271
RR MEDICARE - PH&S
OR
Enumeration date
05/24/2006
Last updated
03/09/2021
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