Provider Demographics
NPI:1659593929
Name:STOYANOVA, VENETA DIMITROVA (MD)
Entity Type:Individual
Prefix:DR
First Name:VENETA
Middle Name:DIMITROVA
Last Name:STOYANOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 NE 5TH ST
Mailing Address - Street 2:FAMILY AND YOUTH PROGRAMS
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128
Mailing Address - Country:US
Mailing Address - Phone:503-957-4185
Mailing Address - Fax:503-418-5775
Practice Address - Street 1:420 NE 5TH ST
Practice Address - Street 2:FAMILY AND YOUTH PROGRAMS
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-957-4185
Practice Address - Fax:503-418-5775
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD258642084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry