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General NPI Number Information
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NPI Number | 1497220941
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Entity Type | Individual
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Provider Name | STACI RENAE MONROE OTD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 2274 SW 2ND ST
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City | MCMINNVILLE
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State | OR
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Zip | 97128-5597
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Country | US
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Telephone | 971-261-2159
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Fax | 503-266-8632
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Provider Business Mailing Address
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Address Line | 610 HIGH ST
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City | OREGON CITY
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State | OR
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Zip | 97045-2241
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Country | US
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Telephone | 971-261-2159
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Fax | 503-266-8632
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 41084
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License Number State | OR
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