Individual
JASON STUTZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7916 SE FOSTER RD STE 201, PORTLAND, OR 97206-4289
(503) 465-2749
Mailing address
PO BOX 16576, PORTLAND, OR 97292-0576
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000002872
—
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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