Individual
SUSAN BROOKE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9427 SW BARNES RD, SUITE 395, PORTLAND, OR 97225-6652
(503) 216-2602
(503) 216-2639
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
096006702N7
OR
363L00000X
Nurse Practitioner
AP30004739
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239269
—
OR
05
—
9622606
—
WA
Enumeration date
06/04/2006
Last updated
11/09/2012
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