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Individual

MS. SUSAN L SKINNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM CFNP

Contact information

Practice address
595 18TH ST, ASTORIA, OR 97103
(503) 325-9131
(503) 325-8797
Mailing address
595 18TH ST, ASTORIA, OR 97103
(503) 325-9131
(503) 325-8797

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000038195
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117572
OR
Enumeration date
04/17/2006
Last updated
01/20/2010
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