Individual
DANIELLE NICOLE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
445 3RD AVE SW, ALBANY, OR 97321-2272
(541) 967-3866
Mailing address
689 ERIC DR, MOLALLA, OR 97038-5601
(503) 806-2754
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230442
DMAP
OR
Enumeration date
02/26/2008
Last updated
07/06/2011
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