Individual
SUSAN M AGRICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
9843 SW ALSEA DR, TUALATIN, OR 97062-9543
(503) 612-0449
Mailing address
PO BOX 826, TUALATIN, OR 97062-0826
(503) 612-0449
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
12120
OR
Other
Enumeration date
07/09/2009
Last updated
07/07/2015
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