Individual
BESSIE-JANE MARIE SULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 W EXCHANGE ST, ASTORIA, OR 97103-6142
(503) 389-6332
(503) 207-6950
Mailing address
263 W EXCHANGE ST, ASTORIA, OR 97103-6142
(503) 389-6332
(503) 207-6950
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200942608RN
OR
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
200942608RN
OR
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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