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Individual

STACEY A WENZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17020 SW UPPER BOONES FERRY RD.,SUITE 201, TIGARD, OR 97224
(503) 894-1539
Mailing address
17020 SW UPPER BOONES FERRY RD., SUITE 201, TIGARD, OR 97224
(503) 894-1539
(503) 210-1453

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
16420
OR

Other

Enumeration date
12/05/2018
Last updated
12/05/2018
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