NPI 1972623510 · live from the CMS NPI Registry
Susan Bennett, PhD
Psychologist in Portland, OR. National Provider Identifier 1972623510, active.
NPI record
| NPI | 1972623510 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist 103T00000X |
| Practice location | 4915 N Interstate Ave, Portland, OR 97217 |
| Practice phone | 503-705-3852 |
| Enumerated | March 29, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist primary | 103T00000X | 749 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.