Omura, Susan E
Omura, Susan E is an individual health care provider with primary practice located at 2801 N Gantenbein Ave , Portland OR 97227-1623. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Omura, Susan E can be contacted via phone (503) 413-4121.Contact Information
Primary practice address
2801 N Gantenbein Ave
Portland OR 97227-1623
Phone: (503) 413-4121
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD23697 | Oregon |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | MD23697 | Oregon |
Profile Details
| NPI number | 1477576239 |
|---|---|
| LBN Legal business name | Omura, Susan E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Feb 4th, 2019 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477576239 | NPPES |
| Oregon | MEDICAID | 286909 |
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