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1295452761
STACEY LAROSE DAVIS
PORTLAND, OR
NPI
1295452761
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-10-25
Last Update Date
2022-10-25
Business Address
STACEY LAROSE DAVIS
2208 SE 182ND AVE
PORTLAND, OR 97233-5608
Phone number: 503-797-7222
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Mailing Address
STACEY LAROSE DAVIS
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-234-9591
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