| Sangsuree Wellness | |
|
5510 N Commercial Ave Portland OR 97217-2340 | |
| (503) 332-7003 | |
| Not Available |
| Full Name | Sangsuree Wellness |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5510 N Commercial Ave, Portland, Oregon |
| Authorized Official Name and Position | Michaela Davis (OFFICE MANAGER) |
| Authorized Official Contact | 5039019508 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sangsuree Wellness 4207 Se Woodstock Blvd Po Box 298 Portland OR 97206-6267 Ph: (503) 332-7003 | Sangsuree Wellness 5510 N Commercial Ave Portland OR 97217-2340 Ph: (503) 332-7003 |
| NPI Number | 1235790304 |
|---|---|
| Provider Enumeration Date | 06/27/2019 |
| Last Update Date | 06/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235790304 | NPI | - | NPPES |
| 500718615 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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