Healthcare Provider Details

I. General information

NPI: 1467378257
Provider Name (Legal Business Name): DANI STANFIELD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DANI EDWARD STANFIELD II

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 NE 44TH AVE STE 310
PORTLAND OR
97213-1468
US

IV. Provider business mailing address

4712 N WILLIAMS AVE APT 302
PORTLAND OR
97217-2886
US

V. Phone/Fax

Practice location:
  • Phone: 503-320-7136
  • Fax:
Mailing address:
  • Phone: 254-709-4936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: