Individual
STACEY WINDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
049 SW PORTER ST, PORTLAND, OR 97201-4848
(503) 552-1551
Mailing address
14635 SW QUAIL LN APT N103, BEAVERTON, OR 97007-7670
(513) 313-1494
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
4022
OR
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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