Bobenrieth, Susanne K

Bobenrieth, Susanne K is an individual health care provider with primary practice located at 1321 Ne 99Th Ave Suite 200, Portland OR 97220-9436. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bobenrieth, Susanne K can be contacted via phone (503) 215-4250.

Contact Information

Primary practice address
1321 Ne 99Th Ave Suite 200 Portland OR 97220-9436
Phone: (503) 215-4250
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD23038 Oregon

Profile Details

NPI number 1871577742
LBN Legal business name Bobenrieth, Susanne K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Feb 15th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871577742 NPPES
Washington MEDICAID 8280463
Washington MEDICAID 287472
Washington Other P00946508
Washington Other 0155143

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