Individual
STACY MARTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
22855 NE PARK LN, WOOD VILLAGE, OR 97060-2606
(503) 492-5033
Mailing address
18815 NE CLACKAMAS ST, PORTLAND, OR 97230-7138
(971) 678-5045
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0015638
OR
Other
Enumeration date
10/30/2016
Last updated
10/30/2016
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