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General NPI Number Information
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NPI Number | 1730423716
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Entity Type | Individual
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Provider Name | SUSANNE MARIE BREEN N.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 11030 SW CAPITOL HWY STE 200
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City | PORTLAND
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State | OR
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Zip | 97219-8653
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Country | US
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Telephone | 503-477-7602
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Fax | 971-288-1303
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Provider Business Mailing Address
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Address Line | 11030 SW CAPITOL HWY STE 200
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City | PORTLAND
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State | OR
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Zip | 97219-8653
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Country | US
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Telephone | 503-477-7602
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Fax | 971-288-1303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 3042
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License Number State | OR
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