Provider Demographics
NPI:1659750198
Name:STEBEL, CHELSEA B (OD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:B
Last Name:STEBEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3505
Mailing Address - Country:US
Mailing Address - Phone:479-276-5947
Mailing Address - Fax:
Practice Address - Street 1:553 18TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3505
Practice Address - Country:US
Practice Address - Phone:503-325-4401
Practice Address - Fax:503-325-4449
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60560938152W00000X
OR3601ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist