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General NPI Number Information
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NPI Number | 1083849798
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Entity Type | Individual
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Provider Name | JEAN MARIE STAGER M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 2701 NW VAUGHN ST., STE 140
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City | PORTLAND
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State | OR
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Zip | 97210
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Country | US
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Telephone | 503-499-5200
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Fax | 503-499-5213
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Provider Business Mailing Address
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Address Line | 2701 NW VAUGHN ST STE 140
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City | PORTLAND
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State | OR
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Zip | 97210-5344
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Country | US
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Telephone | 503-499-5200
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Fax | 503-499-5213
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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