Individual
DR. MARY SUSANNE PLACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1430 MONMOUTH ST, INDEPENDENCE, OR 97351-1127
(503) 838-1133
(503) 838-5138
Mailing address
PO BOX 309, INDEPENDENCE, OR 97351-0309
(503) 838-1133
(503) 838-5138
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD167924
OR
207Q00000X
Family Medicine Physician
MR-1208
ID
Other
Enumeration date
06/15/2011
Last updated
09/04/2014
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