Individual
JAMES STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1014 BURRELL AVE, LEWISTON, ID 83501-5589
(208) 743-4558
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(208) 871-8312
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PTA-6295
ID
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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