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NPI Code Detail

MEDICARE: MRS. CHRISTINA JEAN STAMBAUGH

MEDICARE: MRS. CHRISTINA JEAN STAMBAUGH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator1154467017OR

General Provider Information

NPI Number : 1154467017
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA JEAN STAMBAUGH
Provider Business Mailing Address
First Line : 1375 SE MONMOUTH CUT OFF RD
Second Line :
City : DALLAS
State : OR
Zip : 97338-9504
Country : US
Telephone Number : 503-623-4866
Fax Number :
Provider Business Practice Location Address
First Line : 3321 HAROLD DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1339
Country : US
Telephone Number : 503-399-5597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. CHRISTINA JEAN STAMBAUGH ” Practice Location

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