Individual
MS. SUZANNE C. COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 249-3434
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 249-3434
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
200050043NP
OR
363LA2200X
Adult Health Nurse Practitioner
025804AP30006101
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
200050043NP
OR
363LF0000X
Family Nurse Practitioner
200050043
OR
Other
Enumeration date
10/04/2006
Last updated
11/09/2017
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