Individual
THERESA SUE SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9555 SW BARNES RD, SUITE 100, PORTLAND, OR 97225-6663
(503) 292-3577
(503) 292-3947
Mailing address
8906 SPANISH RIDGE AVE STE 202, LAS VEGAS, NV 89148-1319
(702) 330-3102
(702) 912-4994
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
16725
NV
207V00000X
Obstetrics & Gynecology Physician
MD 16192
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286846
—
OR
01
—
R114215
MEDICARE PTAN
OR
Enumeration date
11/21/2005
Last updated
10/24/2017
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