Provider Demographics
NPI:1891982286
Name:SUITER, JAMES EDWARD (FNP-BC / GNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:SUITER
Suffix:
Gender:M
Credentials:FNP-BC / GNP-BC
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Mailing Address - Street 1:5 CENTERPOINTE DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8651
Mailing Address - Country:US
Mailing Address - Phone:541-914-6421
Mailing Address - Fax:855-821-5123
Practice Address - Street 1:5 CENTERPOINTE DRIVE
Practice Address - Street 2:SUITER 600
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8662
Practice Address - Country:US
Practice Address - Phone:541-914-6421
Practice Address - Fax:855-821-5123
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR200750074NP FNP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORLIPA:JAMES E. SUITEROtherLIPA
OR200750074NP FNP-PPOtherOREGON STATE BOARD OF NURSING --FNP
OR200880005DPOtherOREGON STATE BOARD OF NURSING DISPENSING PRIVELAGES
OR241776Medicaid
12260994OtherCAQH
DCMS1629267OtherDEA: SCHEDULES 2, 2N, 3, 3N, 4, 5
ORLIPA:JAMES E. SUITEROtherLIPA