Individual
MS. SUSAN D PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
10180 SE SUNNYSIDE RD, CARDIOLOGY, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
1828 SE 42ND AVE, PORTLAND, OR 97215-3755
(503) 236-8836
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
OR 087006173N3
OR
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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