Individual
DR. STEPHANIE ANN GROOTENDORST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
9643 NW MARING DR, PORTLAND, OR 97229-5275
(503) 292-8781
Mailing address
9643 NW MARING DR, PORTLAND, OR 97229-5275
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2874
OR
111N00000X
Chiropractor
2884
WA
111N00000X
Chiropractor
2926
WI
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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