Provider Demographics
NPI:1679330633
Name:FERRAIZ, STEFANI
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:FERRAIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEFDANI
Other - Middle Name:DYAN
Other - Last Name:MAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1750 NEBRASKA AVE BLDG A
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5700
Mailing Address - Country:US
Mailing Address - Phone:541-956-4943
Mailing Address - Fax:
Practice Address - Street 1:1920 SW KURTZ LN
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2803
Practice Address - Country:US
Practice Address - Phone:541-295-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist