Individual
SUZANNE M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9427 SW BARNES RD, SUITE 498, PORTLAND, OR 97225-6652
(503) 216-0900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD12269
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261263
—
OR
01
—
P00241488
RR MEDICARE
—
01
—
P00848654
RR MEDICARE (PROVIDENCE)
OR
Enumeration date
06/20/2006
Last updated
01/22/2013
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