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Individual

STEPHANIE O'CONNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
18750 SE STARK ST, PORTLAND, OR 97233-5330
(541) 296-7677
Mailing address
1229 EUGENE ST, HOOD RIVER, OR 97031-1435
(541) 400-0367

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200450105NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0223414
WA L&I
05
022961
OR
01
858543038
REGENCE BLUE CROSS
01
8945123
WA CRIME VICTIMS
05
9643768
WA
Enumeration date
11/18/2005
Last updated
02/07/2013
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