Individual
JEREMY SUCHANSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-8877
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
200211902CNA
OR
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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