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STACY MEDOF THW, PSS, PWS
NPI 1124902507
Peer Specialist in Beaverton, OR

Active since July 31, 2025
4200 SW 107TH AVE APT 2105, BEAVERTON, OR 97005(818) 826-3277 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stacy Medof Thw, Pss, Pws NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY MEDOF THW, PSS, PWS (NPI 1124902507) is an individual peer specialist in Beaverton, Oregon, licensed in Oregon (107826) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1124902507
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameSTACY MEDOFCredential: THW, PSS, PWS
Location Address4200 SW 107TH AVE APT 2105Beaverton, OR 97005-3154
Mailing Address4200 Sw 107th Ave Apt 2105Beaverton, OR 97005-3154
Phone(818) 826-3277
Sole ProprietorYes
Enumeration DateJuly 31, 2025
NPPES CertifiedJuly 31, 2025
✔ NPI 1124902507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · 107826
Definition
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.
4200 SW 107TH AVE APT 2105, Beaverton, OR 97005
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Medof's NPI number?

The NPI number for Stacy Medof is 1124902507. It was assigned to this individual provider in the NPPES registry on July 31, 2025.

Where is Stacy Medof located?

Stacy Medof practices at 4200 SW 107th Ave Apt 2105, Beaverton, OR 97005. The listed phone number is (818) 826-3277.

What is Stacy Medof's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Stacy Medof was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.