Individual
SUZANNE BERNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
(503) 853-9789
(971) 246-5199
Mailing address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
(503) 853-9789
(971) 246-5199
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
L5638
OR
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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