Individual
MARCELLE CHRISTINE STOOKSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSR
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
8927 N GENEVA AVE, PORTLAND, OR 97203-2603
(503) 309-1156
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00951603
OR
Other
Enumeration date
08/21/2006
Last updated
10/30/2012
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