Individual
STACY LYNN RISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC MA CADC QMHP
Contact information
Practice address
131 NE 102ND AVE, PORTLAND, OR 97220-4167
(503) 253-6754
(503) 253-8020
Mailing address
2051 KAEN RD, OREGON CITY, OR 97045-4035
(503) 650-3110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C2406
OR
Other
Enumeration date
01/17/2007
Last updated
09/27/2016
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