Individual
STEPHANIE KENDALL WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NMNP LAC
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 957-3700
(541) 440-3589
Mailing address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 957-3700
(541) 440-3589
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AS152549
OR
367A00000X
Advanced Practice Midwife
Primary
092006677N5
OR
367A00000X
Advanced Practice Midwife
092006677N5-NMPP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05066
—
OR
Enumeration date
03/07/2008
Last updated
11/28/2012
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