Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD24694 | OR |
N | 207VG0400X | Gynecologist | MD24694 | OR |
NPI | 1871546242 |
---|---|
Provider Name | Susan Arden Hobson |
First Address | Portland, OR 97223-8692 |
Second Address | Portland, OR 97225-6772 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 18/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
273228 | (05) | OR |
I39813 | (02) | OR |