Fodell, Susan Ann
Fodell, Susan Ann is an sole proprietor health care provider with primary practice located at 6327 Se Milwaukie Ave , Portland OR 97202-5418. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Fodell, Susan Ann can be contacted via phone (503) 418-2268.Contact Information
Primary practice address
6327 Se Milwaukie Ave
Portland OR 97202-5418
Phone: (503) 418-2268
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 012628 | Oregon |
Profile Details
| NPI number | 1205874096 |
|---|---|
| LBN Legal business name | Fodell, Susan Ann |
| Credentials | CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 3rd, 2006 |
| Last updated | Jul 17th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205874096 | NPPES |
| Oregon | MEDICAID | 269736 |
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