Andrew Stark

NPI #1093123374 in Dallas, Oregon

Provider Information

NPI Number: 1093123374
Entity Type: Individual
Name: Andrew Stark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jul 30, 2014
Last Updated: Jul 30, 2014

Practice Location

Address: 182 SW ACADEMY ST
Address 2: SUITE 333
City: Dallas
State: Oregon
ZIP Code: 97338-1922
Phone: (503) 831-5970

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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