Castle, Susannah Bock

Castle, Susannah Bock is an sole proprietor health care provider with primary practice located at 5200 Sw Macadam Ave Suite 580, Portland OR 97239-6103. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Castle, Susannah Bock can be contacted via phone (503) 970-2942.

Contact Information

Primary practice address
5200 Sw Macadam Ave Suite 580 Portland OR 97239-6103
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1825 Oregon

Profile Details

NPI number 1194925859
LBN Legal business name Castle, Susannah Bock
Credentials PSY.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2007
Last updated Jun 6th, 2008 - about 17 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 1194925859 NPPES
Oregon MEDICAID 245831

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