Individual
MISS SUMMER STONE-DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
Mailing address
12327 SW CANVASBACK WAY, BEAVERTON, OR 97007-6233
(503) 757-1936
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1854
OR
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/03/2021
Last updated
09/13/2022
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