Individual
MARY THERESA STITES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Mailing address
19779 WILDWOOD DR, WEST LINN, OR 97068-2228
(503) 522-3069
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0472
OR
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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