Individual
MICHAEL SUCHOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
(503) 221-3430
Mailing address
PO BOX 865109, ORLANDO, FL 32886-5109
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
ABC02970
OR
224P00000X
Prosthetist
ABC02970
OR
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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