Individual
SUSAN T. SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2800 N VANCOUVER AVE, SUITE 201, PORTLAND, OR 97227-1630
(503) 331-2400
(503) 331-2410
Mailing address
2800 N VANCOUVER AVE, SUITE 201, PORTLAND, OR 97227-1630
(503) 331-2400
(503) 331-2410
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD17912
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069828
—
OR
05
—
9637869
—
WA
Enumeration date
03/19/2007
Last updated
07/08/2007
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