Individual
AMY STOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20887 SW MARTINI CT, ALOHA, OR 97078-4050
(503) 372-6403
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/16/2014
Last updated
02/19/2015
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