Provider Demographics
NPI:1932672698
Name:MORRIS, SUZANNE M (LMT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 SW 197TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97003-2543
Mailing Address - Country:US
Mailing Address - Phone:971-245-0868
Mailing Address - Fax:
Practice Address - Street 1:446 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4187
Practice Address - Country:US
Practice Address - Phone:971-245-0868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-05
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24808225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist