Stacey Martin
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1982186946
StatusActive
Last updated in NPPESSep 23, 2020
Details
- NPI
- 1982186946
- Entity type
- Individual (NPI-1)
- Name
- Stacey Martin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 5, 2018
- Certification date
- Sep 23, 2020
- Last updated
- Sep 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Other names
- Stacey Ziegenhagel (Former Name)
Practice location
3036 Ne Mlk Jr BlvdPortland, OR 97212-3053
Phone 503-889-2500
Mailing address
Po Box 8459Portland, OR 97207-8459
Phone 503-238-0769
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