NPI 1245590553
Thora Jane Stacy, CDAEFDA
Practice location
- Address
- 2300 N.E. Lacncaster Dr., Salem, OR 97303
- Phone
- (503) 370-4313
- Mailing address
- 4255 Cordon Rd NE, Salem, OR 97305-3738
Registered specialties
Dental Assistant
Primary
Registry record
- NPI
- 1245590553
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 21 May 2012
- Record last updated
- 21 May 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.