Basic Information
| Provider Information | |||||||||
| NPI: | 1598717282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEE | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | TROY | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ANP GNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20668 SW 86TH AVE | ||||||||
| Address2: | |||||||||
| City: | TUALATIN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970629101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038857744 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1185 S ELM ST | ||||||||
| Address2: | |||||||||
| City: | CANBY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970133935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037234670 | ||||||||
| FaxNumber: | 5032666649 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | OR | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LG0600X | OR | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.