Provider Demographics
NPI:1639825276
Name:BARKER, STEPHANIE R
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 O AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2427
Mailing Address - Country:US
Mailing Address - Phone:541-805-0891
Mailing Address - Fax:
Practice Address - Street 1:2301 COVE AVE
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-3906
Practice Address - Country:US
Practice Address - Phone:541-962-8800
Practice Address - Fax:541-963-5272
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No175T00000XOther Service ProvidersPeer Specialist