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1982186946
STACEY MARTIN
PORTLAND, OR
NPI
1982186946
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Former Name
STACEY ZIEGENHAGEL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-09-05
Last Update Date
2020-09-23
Business Address
STACEY MARTIN
3036 NE MLK JR BLVD
PORTLAND, OR 97212-3053
Phone number: 503-889-2500
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Mailing Address
STACEY MARTIN
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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