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Contact Information

SHANEEN D STACER, PHD
1900 WOODLAND DR
COOS BAY, OR97420-2045
 Phone: 541-267-5151
 Fax: 541-266-4554
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Health

103TH0004X 62 Psychologist, Clinical
 

Health Service

103TH0100X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for SHANEEN D STACER · (Female)

NPI Number 1427485440
Status Active
Credentials PHD
Entity Individual
Enumeration date 10/04/2013
Last updated 09/08/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 2500
  • WI License # 3079-57
  • OR Medicaid 500684206
  • OR Other 161133 NORTH BEND MEDICAL CENTER GROUP MEDICAID
  • OR Other R0000WFBTV NORTH BEND MEDICAL CENTER GROUP MEDICARE
  • OR Other 1407812365 NORTH BEND MEDICAL CENTER GROUP NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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