Stuart, Tedra

Stuart, Tedra is an sole proprietor health care provider with primary practice located at 3406 Watermark Dr , Springfield OR 97477-6725. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Agencies / In Home Supportive Care. Agencies / In Home Supportive Care is her primary health care specialty. Stuart, Tedra can be contacted via phone (503) 798-0706.

Contact Information

Primary practice address
3406 Watermark Dr Springfield OR 97477-6725
Phone: (503) 798-0706
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C1334 Oregon
Behavioral Health & Social Service Providers / Professional 101YP2500X C1334 Oregon
Agencies / In Home Supportive Care 253Z00000X 859573 Oregon

Profile Details

NPI number 1104076140
LBN Legal business name Stuart, Tedra
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2008
Last updated Sep 22nd, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104076140 NPPES
Oregon MEDICAID 859573

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