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NPI Code Detail

MEDICARE: AMANDA ROSE STOCK

MEDICARE: AMANDA ROSE STOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist64186OR

General Provider Information

NPI Number : 1063277572
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ROSE STOCK
Provider Business Mailing Address
First Line : 936 SE OAK ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4214
Country : US
Telephone Number : 971-259-6916
Fax Number :
Provider Business Practice Location Address
First Line : 936 SE OAK ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4214
Country : US
Telephone Number : 971-259-6916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2024
Last Update Date : 03/20/2026

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Directions to “ AMANDA ROSE STOCK ” Practice Location

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