Individual
DR. SUSAN THERESA HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 813-2000
Mailing address
2670 BROADWAY AVE, PMB 17, NORTH BEND, OR 97459
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
052948
GA
207P00000X
Emergency Medicine Physician
Primary
MD23325
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000ZGBJD
GROUP MEDICARE #
OR
01
—
1225016561
GROUP NPI #
OR
05
—
275193
—
OR
Enumeration date
02/23/2007
Last updated
04/11/2023
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