Individual
SUSAN E OMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25050 SE STARK ST STE 300, GRESHAM, OR 97030-3388
(503) 667-8878
(503) 667-0310
Mailing address
25050 SE STARK ST STE 300, GRESHAM, OR 97030-3388
(503) 667-8878
(503) 667-0310
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
MD23697
OR
208000000X
Pediatrics Physician
Primary
MD23697
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286909
—
OR
Enumeration date
07/25/2006
Last updated
03/06/2026
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