Individual
SUSAN RUTH EKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1217 NE BURNSIDE RD STE 503C, GRESHAM, OR 97030-5770
(971) 888-2014
(971) 206-6387
Mailing address
644 SW WALTERS DR, GRESHAM, OR 97080-9351
(971) 888-2014
(971) 206-6387
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
077037817N2
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
077037817N2
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200250006NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077037817N2-PNP-PP
NURSEPRACTITIONER LICENSE
OR
Enumeration date
06/04/2007
Last updated
09/13/2023
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