Provider Demographics
NPI:1235544099
Name:HAPP, SUSAN ERIKA (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ERIKA
Last Name:HAPP
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 NE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-6107
Mailing Address - Country:US
Mailing Address - Phone:503-358-2874
Mailing Address - Fax:
Practice Address - Street 1:5715 NE 25TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-6107
Practice Address - Country:US
Practice Address - Phone:503-358-2874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096000345RN163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR11132550OtherIBCLC