Individual provider · Type 1 NPI
Stacy Medof, THW, PSS, PWS
Peer Specialist · Beaverton, OR
NPI number
1124902507
Active
Practice location
4200 SW 107th Ave Apt 2105
Beaverton, OR 97005-3154
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | 107826 (OR) |
Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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About NPI 1124902507
Stacy Medof, THW, PSS, PWS's National Provider Identifier is 1124902507, issued on Jul 31, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Beaverton, OR. The record was last updated on Jul 31, 2025.