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Provider Information for 1245271246


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Ms. DENISE E. STUNTZNER LCSW


Sex: Female

NPI: 1245271246
Last Updated: 2019-11-06
Certification Date:

Details

NameValue
NPI1245271246
Enumeration Date2006-06-09
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 125 CENTRAL AVE
STE 290
COOS BAY, OR 97420-2342
United States

Phone: 541-267-5151 | Fax:
 
Primary Practice Address 1900 WOODLAND DR
COOS BAY, OR 97420-2045
United States

Phone: 541-267-5151 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)OR1407812365NORTH BEND MEDICAL CENTER GROUP NPI
Other (non-Medicare)OR161133NORTH BEND MEDICAL CENTER GROUP MEDICAID
Other (non-Medicare)OR93-0635514NORTH BEND MEDICAL CENTER GROUP TAX ID
Other (non-Medicare)ORR0000WFBTVNORTH BEND MEDICAL CENTER GROUP MEDICARE
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalORL3811