Individual ProviderEvan Spencer StacyAcupuncturistOther Service ProvidersPractice Address2 NW 3rd Ave, Portland, OR 97209-3907(503) 841-6828(540) 449-5664PECOS EnrollmentBased on the most recent information from CMS, provider Evan Spencer Stacy does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1285060020Provider TypeIndividualFull NameStacy, Evan SpencerCredentialL.ACGenderMaleSole ProprietorYesEnumeration Date9/25/2013Last Updated9/25/2013Contact InformationPractice LocationPractice Address2 NW 3rd Ave, Portland, OR 97209-3907Phone(503) 841-6828FaxUnlisted FaxMailing LocationMailing Address715 SW King Ave Apt 4, Portland, OR 97205-1403Phone(540) 449-5664FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicenseAC153198Oregon