Individual
SUSAN M HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
870 S FRONT ST, SUITE 200, CENTRAL POINT, OR 97502-2779
(541) 664-3346
(541) 664-6051
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 664-3346
(541) 664-6051
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00036325
WA
207R00000X
Internal Medicine Physician
Primary
MD19220
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212995
—
OR
05
—
227698
—
OR
Enumeration date
06/07/2006
Last updated
01/30/2012
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