Doctor Name: | PAUL K STEWART |
NPI Number: | 1134327075 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, CADCIII |
License Number: | 96-10-162 |
Business Practice Address: | 11211 Se 82nd Ave Suite O Happy Valley, OR - 970867624 |
Business Phone Number: | 5037226200 |
Business Fax Number: | 5037226545 |
Mailing Address: | 2051 Kaen Rd, Suite 367 OREGON CITY |
State: | OR |
Postal Code: | 970454035 |
Phone Number: | 5037425300 |
Fax Number: | 5037425979 |
NPI Enumeration Date: | 07/03/2007 |
NPI Last Update Date: | 12/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 96-10-162 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |