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Individual

MRS. SUSAN LEE WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200350114NP FNP PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
082010084RN
OREGON LICENSE NUMBER
OR
Enumeration date
10/14/2005
Last updated
07/11/2016
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