Provider Demographics
NPI:1962696468
Name:STEIN, JOSEPH PAUL
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL
Last Name:STEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39302 STRATFORD PL
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-5314
Mailing Address - Country:US
Mailing Address - Phone:971-241-0232
Mailing Address - Fax:
Practice Address - Street 1:39302 STRATFORD PL
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-5314
Practice Address - Country:US
Practice Address - Phone:971-241-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider