Individual
MS. STACEY J BROWN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
19875 SW 65TH AVE, TUALATIN, OR 97062-8353
(503) 692-2657
Mailing address
1250 NW 97TH AVE, PORTLAND, OR 97229-5208
(503) 297-8725
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0971
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049838
OMAP
OR
Enumeration date
06/06/2006
Last updated
07/08/2007
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