| NPI | 1710266226 |
|---|---|
| Former Name | ANNE STARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201150100NP) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OR 200942680RN) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2018-03-29 |