Individual
STUART G STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6840 S MACADAM AVE, PORTLAND, OR 97219-2314
(503) 936-8640
(503) 907-7779
Mailing address
333 NW 9TH AVE UNIT 1110, PORTLAND, OR 97209-3345
(503) 936-8640
(503) 907-7779
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1472
OR
Other
Enumeration date
06/15/2006
Last updated
01/26/2022
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