Individual
SUSAN K PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LMP
Contact information
Practice address
2191 NW 2ND ST, MCMINNVILLE, OR 97128-9108
(503) 434-2824
Mailing address
2191 NW 2ND ST, MCMINNVILLE, OR 97128-9108
(503) 434-2824
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4993
OR
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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