Healthcare Provider Details

I. General information

NPI: 1265590509
Provider Name (Legal Business Name): SUZANNE RUTH HURFORD CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD UHS 8Z
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3328 NE JESSUP ST
PORTLAND OR
97211-7423
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-6022
  • Fax:
Mailing address:
  • Phone: 503-493-2390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: