Provider Demographics
NPI:1306455266
Name:STULL, LAUREN (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:STULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:534 PLEASANT VIEW WAY NW STE 100
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1789
Mailing Address - Country:US
Mailing Address - Phone:541-812-5656
Mailing Address - Fax:541-663-4122
Practice Address - Street 1:534 PLEASANT VIEW WAY NW STE 100
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1789
Practice Address - Country:US
Practice Address - Phone:541-812-5656
Practice Address - Fax:541-663-4122
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43510483072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry