Stack, Sean

Stack, Sean is an individual health care provider with primary practice located at 2925 Ryan Dr Se , Salem OR 97301-9687. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Stack, Sean can be contacted via phone (503) 399-1264.

Contact Information

Primary practice address
2925 Ryan Dr Se Salem OR 97301-9687
Phone: (503) 399-1264
Fax: (503) 371-0777
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 20801 Oregon
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD20801 Oregon

Profile Details

NPI number 1962453217
LBN Legal business name Stack, Sean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Nov 22nd, 2023 - about last year

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 1962453217 NPPES
Oregon MEDICAID 288438

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