Provider Demographics
NPI:1508280959
Name:STUMPF, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:STUMPF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:ANN
Other - Last Name:FELLOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4022 N ALBINA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1210
Mailing Address - Country:US
Mailing Address - Phone:914-319-9955
Mailing Address - Fax:
Practice Address - Street 1:4022 N ALBINA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1210
Practice Address - Country:US
Practice Address - Phone:914-319-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker