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NPI Code Detail

MEDICARE: DR. SUZANNE KATHRYN WELCH P.T.

MEDICARE: DR. SUZANNE KATHRYN WELCH P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist6873OR

General Provider Information

NPI Number : 1023363504
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZANNE KATHRYN WELCH P.T.
Provider Business Mailing Address
First Line : 5316 E BURNSIDE ST # 14
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1211
Country : US
Telephone Number : 563-590-4323
Fax Number :
Provider Business Practice Location Address
First Line : 7203 SE RAYMOND ST
Second Line :
City : PORTLAND
State : OR
Zip : 97206-4323
Country : US
Telephone Number : 503-750-5926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2012
Last Update Date : 07/19/2012

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Directions to “ DR. SUZANNE KATHRYN WELCH P.T.” Practice Location

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