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1356189807
MADELYN AILEEN STOCKSLAGER
CANBY, OR
NPI
1356189807
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR AT-10245509)
Enumeration Date
2024-07-18
Last Update Date
2024-07-18
Business Address
MADELYN AILEEN STOCKSLAGER MATRN, LAT
721 SW 4TH AVE
CANBY, OR 97013-3999
Phone number: 503-263-7200
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Mailing Address
MADELYN AILEEN STOCKSLAGER MATRN, LAT
17124 SW APPLEDALE RD UNIT 304
BEAVERTON, OR 97007-2035
Phone number: 310-612-1071
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