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General NPI Number Information
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NPI Number | 1346086345
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Entity Type | Individual
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Provider Name | ALEXANDRA IRENE STEMM ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 07/08/2024
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 801 FERRY ST
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City | DAYTON
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State | OR
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Zip | 97114-9709
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Country | US
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Telephone | 503-864-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 SW PICKFORD ST UNIT 103
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City | CORVALLIS
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State | OR
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Zip | 97333-1664
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Country | US
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Telephone | 909-276-9225
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT-AT-10245384
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License Number State | OR
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