Doctor Name: | MS. STACY BUNNELL |
NPI Number: | 1902173941 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 16535 Sw Tualatin Valley Hwy Beaverton, OR - 970035143 |
Business Phone Number: | 5032593131 |
Business Fax Number: | 5036497405 |
Mailing Address: | 16535 Sw Tualatin Valley Hwy, BEAVERTON |
State: | OR |
Postal Code: | 970035143 |
Phone Number: | 5032593131 |
Fax Number: | 5036497405 |
NPI Enumeration Date: | 11/18/2011 |
NPI Last Update Date: | 08/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |