Stafford, Dirk William

Stafford, Dirk William is an individual health care provider with primary practice located at 149 S Main St , Phoenix OR 97535-6631. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Stafford, Dirk William can be contacted via phone (541) 535-4133.

Contact Information

Primary practice address
149 S Main St Phoenix OR 97535-6631
Phone: (541) 535-4133
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1558905000
LBN Legal business name Stafford, Dirk William
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2019
Last updated Oct 28th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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