Healthcare Provider Details

I. General information

NPI: 1275461923
Provider Name (Legal Business Name): SUSANNA AGUERO CRM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W SPERRY STREET
HEPPNER OR
97836
US

IV. Provider business mailing address

550 W SPERRY STREET
HEPPNER OR
97836
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-6330
  • Fax:
Mailing address:
  • Phone: 541-278-6330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: