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NPI Code Detail

MEDICARE: AMBER STONE

MEDICARE:   AMBER  STONE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorT-23-2780OR

General Provider Information

NPI Number : 1316725013
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER STONE
Provider Business Mailing Address
First Line : PO BOX 20674
Second Line :
City : KEIZER
State : OR
Zip : 97307-0674
Country : US
Telephone Number : 503-304-4358
Fax Number : 503-304-4361
Provider Business Practice Location Address
First Line : 147 SW COURT ST
Second Line :
City : DALLAS
State : OR
Zip : 97338-3112
Country : US
Telephone Number : 503-304-4358
Fax Number : 503-304-4361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2023
Last Update Date : 09/15/2023

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Directions to “ AMBER STONE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.