Provider Demographics
NPI:1003522301
Name:GIVEN, STEPHANIE (MSCN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:GIVEN
Suffix:
Gender:F
Credentials:MSCN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSCN
Mailing Address - Street 1:2802 SW BEAVERTON HILLSDALE HWY APT A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-1168
Mailing Address - Country:US
Mailing Address - Phone:401-266-4123
Mailing Address - Fax:
Practice Address - Street 1:2802 SW BEAVERTON HILLSDALE HWY APT A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1168
Practice Address - Country:US
Practice Address - Phone:401-266-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist