Individual
DR. SANDRA J KRUSSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2250 NW FLANDERS ST, SUITE 306, PORTLAND, OR 97210-3443
(503) 226-0558
(503) 276-1284
Mailing address
2250 NW FLANDERS ST, SUITE 306, PORTLAND, OR 97210-3443
(503) 226-0558
(503) 276-1284
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
DO152642
OR
2084P0800X
Psychiatry Physician
Primary
DO152642
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500631009
—
OR
Enumeration date
11/19/2007
Last updated
02/22/2017
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