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General NPI Number Information
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NPI Number | 1699641183
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Entity Type | Organization
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Legal Business Name | SUSANNAH CASTLE PSYD LLC
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1509 SW SUNSET BLVD STE 2C
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City | PORTLAND
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State | OR
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Zip | 97239-2689
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Country | US
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Telephone | 503-970-2942
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Fax | 503-296-2363
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Provider Business Mailing Address
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Address Line | 1509 SW SUNSET BLVD STE 2C
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City | PORTLAND
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State | OR
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Zip | 97239-2689
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Country | US
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Telephone | 503-970-2942
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Fax | 503-296-2363
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. SUSANNAH CASTLE
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Credential | PSYD
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Telephone | 503-970-2942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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