Individual
MICHELLE TRAVERS STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
(855) 524-5255
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD177538
OR
2084N0400X
Neurology Physician
MD61035036
WA
Other
Enumeration date
04/04/2012
Last updated
09/12/2025
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