Elmore, Susan

Elmore, Susan is an individual health care provider with primary practice located at 1631 Sw Columbia St , Portland OR 97201-6025. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Elmore, Susan can be contacted via phone (503) 231-2641.

Contact Information

Primary practice address
1631 Sw Columbia St Portland OR 97201-6025
Fax: (503) 261-1654
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X MD19811 Oregon

Profile Details

NPI number 1770573354
LBN Legal business name Elmore, Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Jul 8th, 2007 - 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 1770573354 NPPES
Oregon MEDICAID 126370

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