Individual
STACEY DIANE BEEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(971) 806-0686
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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