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NPI Code Detail

MEDICARE: MAYA STOUT

MEDICARE: MAYA STOUT
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
1101Y00000XCounselorOR

General Provider Information

NPI Number : 1417804519
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA STOUT
Provider Business Mailing Address
First Line : 2480 NE TWIN KNOLLS DR
Second Line :
City : BEND
State : OR
Zip : 97701-6833
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2480 NE TWIN KNOLLS DR
Second Line :
City : BEND
State : OR
Zip : 97701-6833
Country : US
Telephone Number : 541-758-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ MAYA STOUT ” Practice Location

Language Start Address Practice Location
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.

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