Individual
SUSAN A NOSACKA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
2330 NW FLANDERS ST, STE G-1, PORTLAND, OR 97210-3442
(503) 224-9270
(503) 224-9271
Mailing address
2330 NW FLANDERS ST, STE G-1, PORTLAND, OR 97210-3442
(503) 224-9270
(503) 224-9271
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
339036
OR
225XH1200X
Hand Occupational Therapist
OT00004143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135299
WA L&I
WA
05
—
226657
—
OR
05
—
8419947
—
WA
Enumeration date
12/12/2005
Last updated
07/09/2007
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