Susan E Omura
Pediatrician Pediatric Emergency Physician
2801 N Gantenbein Ave
Portland
, Oregon 97227-1623
Susan E Omura
Pediatrician Pediatric Emergency Physician
2801 N Gantenbein Ave
Portland
, Oregon 97227-1623
(503) 464-9034
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About
Features
Specialties
- Pediatric Emergency Physician
- Pediatrician
Languages spoken
- English
Location
First Address
- Susan E Omura
- 6312 Sw Capitol Hwy #502
- Portland, OR
- Zip : 97239-1938
- Phone : (503) 464-9034
Second Address
- Susan E Omura
- 2801 N Gantenbein Ave
- Portland, OR
- Zip : 97227-1623
- Phone : (503) 413-4121
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | MD23697 | OR |
| N | 208000000X | Pediatrician | MD23697 | OR |
National Provider Identifier
| NPI | 1477576239 |
|---|---|
| Provider Name | Susan E Omura |
| First Address | Portland, OR 97239-1938 |
| Second Address | Portland, OR 97227-1623 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| Last Update Date | 04/02/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 286909 | (05) | OR |
| F80280 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.