Individual
SUSAN BERNIER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDE/RN
Contact information
Practice address
1698 E MCANDREWS RD, SUITE 170, MEDFORD, OR 97504-5589
(541) 732-6957
(541) 732-7901
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-6957
(541) 732-7901
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
097006478RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20220359
CERTIFIED DIABETIC EDUCATOR
OR
Enumeration date
06/15/2009
Last updated
12/04/2012
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