Individual
ISAAC SUAREZ-NUGENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2740 SE POWELL BLVD, PORTLAND, OR 97202-2069
(503) 238-5196
Mailing address
5205 E BURNSIDE ST APT 15, PORTLAND, OR 97215-1183
(404) 580-7944
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
08/17/2020
Last updated
01/21/2021
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