Anderson, Stacy M

Anderson, Stacy M is an individual health care provider with primary practice located at 1475 Mt. Hood Ave , Woodburn OR 97071. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Anderson, Stacy M can be contacted via phone (971) 983-5214.

Contact Information

Primary practice address
1475 Mt. Hood Ave Woodburn OR 97071
Phone: (971) 983-5214
Fax: (971) 983-5219
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X 200850153NPPMHNP-PP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 200850153NP Oregon

Profile Details

NPI number 1518139617
LBN Legal business name Anderson, Stacy M
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2008
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518139617 NPPES
Oregon MEDICAID 500673539
Oregon MEDICAID 500601826

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