Individual
SUSAN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
1723 SW MARTHA ST, PORTLAND, OR 97239-2715
(907) 351-8320
Mailing address
1723 SW MARTHA ST, PORTLAND, OR 97239-2715
(907) 351-8320
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
0649
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022527
—
AK
Enumeration date
11/16/2006
Last updated
07/16/2014
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