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General NPI Number Information
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NPI Number | 1982564837
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Entity Type | Organization
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Legal Business Name | DEBORA A. STOUT, PMHNP, LLC
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 20 BASIN ST STE 106
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City | ASTORIA
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State | OR
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Zip | 97103-6237
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Country | US
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Telephone | 503-338-6106
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Fax | 503-338-6126
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Provider Business Mailing Address
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Address Line | PO BOX 1310
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City | ASTORIA
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State | OR
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Zip | 97103-1310
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Country | US
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Telephone | 503-338-6106
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Fax | 503-338-6126
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Authorized Official
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Title or Position | OWNER / OPERATOR
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Name | DDEBORA ANNE STOUT
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Credential | PMHNP
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Telephone | 503-338-6106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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