Individual
J SUZANNE NELSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2525 NW LOVEJOY ST, STE 200, PORTLAND, OR 97210-2863
(503) 227-0671
(503) 227-0676
Mailing address
4103 SW MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 636-4508
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
000038085N2
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035282
—
OR
Enumeration date
06/22/2005
Last updated
07/08/2007
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