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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 19 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 1205874096 NPPES
Oregon MEDICAID 269736

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