Individual
SUSAN CARMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
847 NE 19TH AVE, SUITE 100, PORTLAND, OR 97232-2684
(503) 528-0757
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
200441469RN
OR
171M00000X
Case Manager/Care Coordinator
Primary
2004414691RN
OR
Other
Enumeration date
05/21/2013
Last updated
05/31/2016
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