Individual
SUSAN D FORDICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2013 SW OLSON AVE, PENDLETON, OR 97801-4421
(541) 240-1446
Mailing address
2013 SW OLSON, PENDLETON, OR 97801
(541) 240-1446
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/09/2013
Last updated
10/09/2013
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