Individual
SUSANN BEAULIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2112 BROADWAY ST, NORTH BEND, OR 97459-2330
(541) 756-6337
(541) 751-9908
Mailing address
2112 BROADWAY ST, NORTH BEND, OR 97459-2330
(541) 756-6337
(541) 751-9908
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HAS-P-1002441
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298922
—
OR
Enumeration date
06/15/2007
Last updated
07/09/2007
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