Provider Demographics
NPI:1023887437
Name:STONE, SONYA LYNN
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:LYNN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SMITH
Mailing Address - Street 1:1851 NW CIVIC DR
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5566
Mailing Address - Country:US
Mailing Address - Phone:971-292-1050
Mailing Address - Fax:
Practice Address - Street 1:1851 NW CIVIC DR
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5566
Practice Address - Country:US
Practice Address - Phone:971-292-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician