Provider Demographics
NPI:1982721239
Name:STIEPER, CAROL (MA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:STIEPER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15214 SW TEAL BLVD
Mailing Address - Street 2:E
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-7643
Mailing Address - Country:US
Mailing Address - Phone:503-747-2211
Mailing Address - Fax:
Practice Address - Street 1:9330 59TH AVENUE SW
Practice Address - Street 2:GREATER LAKES MENTAL HEALTH CENTER
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-6600
Practice Address - Country:US
Practice Address - Phone:253-581-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health