MEDICARE: DR. SUZANNE LANG YOUNGE PHD

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
1	103T00000X	Psychologist	1156	OR

General Provider Information

NPI Number	:	1700943396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE LANG YOUNGE PHD

Provider Business Mailing Address
First Line	:	1327 SE TACOMA ST #174
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-6639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5441 SW MACADAM AVE STE 102
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3821
Country	:	US
Telephone Number	:	503-449-4163
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	02/23/2025

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