Individual
SUSAN VAUGHN MOERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8445 SW WOODSIDE DR, PORTLAND, OR 97225-1737
(503) 292-6271
Mailing address
8445 SW WOODSIDE DR, PORTLAND, OR 97225-1737
(503) 292-6271
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
076037101N3 ANP-PP
OR
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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