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Individual

DR. STACY E. ILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
710 SUNSET DR STE F, LA GRANDE, OR 97850-1200
(541) 663-3100
(541) 975-5135
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 663-3100
(541) 975-5135

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00327200
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP186880
OR

Other

Enumeration date
05/21/2012
Last updated
10/03/2023
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