Provider Demographics
NPI:1043907165
Name:ZAIDEL-STACH, VALERIE ANN (LMFT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:ZAIDEL-STACH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N HAYDEN ISLAND DR UNIT 418
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-8156
Mailing Address - Country:US
Mailing Address - Phone:503-805-4398
Mailing Address - Fax:
Practice Address - Street 1:707 N HAYDEN ISLAND DR UNIT 418
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-8156
Practice Address - Country:US
Practice Address - Phone:503-805-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0519106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty