Individual
MS. SUSAN LYN WAGNER-DEBUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2701 NW VAUGHN ST, PORTLAND, OR 97210-5311
(503) 721-3975
Mailing address
1130 NE 109TH AVE, PORTLAND, OR 97220-3117
(503) 997-6708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
093000287RN
OR
Other
Enumeration date
01/08/2010
Last updated
01/08/2010
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