Individual
DR. SUSANNE DUVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-1557
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2463
OR
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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