Mortenson, Susan Rae
Mortenson, Susan Rae is an individual health care provider with primary practice located at 4855 Sw Western Ave , Beaverton OR 97005-3460. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Mortenson, Susan Rae can be contacted via phone (503) 813-2000.Contact Information
Primary practice address
4855 Sw Western Ave
Beaverton OR 97005-3460
Phone: (503) 813-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1821461146 |
|---|---|
| LBN Legal business name | Mortenson, Susan Rae |
| Credentials | MA, LPC, CRC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2015 |
| Last updated | Oct 13th, 2022 - about 4 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 | 1821461146 | NPPES |
| Oregon | MEDICAID | 274147 |
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