Provider Demographics
NPI:1538282843
Name:HAUGE, SUSAN ELAINE (RN CNOR)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELAINE
Last Name:HAUGE
Suffix:
Gender:F
Credentials:RN CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28925 SE WK ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-6917
Mailing Address - Country:US
Mailing Address - Phone:503-709-3247
Mailing Address - Fax:
Practice Address - Street 1:9155 SW BARNES RD STE 930
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6636
Practice Address - Country:US
Practice Address - Phone:503-297-1515
Practice Address - Fax:503-297-5813
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery