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General NPI Number Information
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NPI Number | 1255276465
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Entity Type | Individual
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Provider Name | STACEY L COME CDAC-R
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Gender | Female
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 1655 SW HIGHLAND AVE STE 5
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City | REDMOND
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State | OR
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Zip | 97756-2558
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Country | US
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Telephone | 541-925-2654
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Fax |
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Provider Business Mailing Address
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Address Line | 61395 WHITE TAIL ST
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City | BEND
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State | OR
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Zip | 97702-2779
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Country | US
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Telephone | 541-306-0286
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Fax | 541-306-0286
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 95386
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License Number State | OR
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