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Individual

MS. SUSAN I VANGORDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3181 SW SAM JACKSON PARK ROAD, OHSU, PORTLAND, OR 97239-3098
(503) 494-8014
(503) 494-2251
Mailing address
3181 SW SAM JACKSON PARK ROAD, OHSU, PORTLAND, OR 97239-3098
(503) 494-8014
(503) 494-2251

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0001131932
VA
207L00000X
Anesthesiology Physician
0024165997
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
OR

Other

Enumeration date
07/19/2005
Last updated
09/19/2007
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