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General NPI Number Information
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NPI Number | 1497123566
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Entity Type | Individual
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Provider Name | MICHELE R. STOKES LMT
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Gender | Female
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 2311 EAST BURNSIDE B1
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City | PORTLAND
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State | OR
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Zip | 97214
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Country | US
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Telephone | 503-830-5691
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Fax |
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Provider Business Mailing Address
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Address Line | 1427 S.E. 30TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214
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Country | US
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Telephone | 503-830-5691
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 5317
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License Number State | OR
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