Provider Demographics
NPI:1548284656
Name:BEST, SUZANNE RAE (PHD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:RAE
Last Name:BEST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SE 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1902
Mailing Address - Country:US
Mailing Address - Phone:503-306-2965
Mailing Address - Fax:503-235-0618
Practice Address - Street 1:7 SE 30TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1902
Practice Address - Country:US
Practice Address - Phone:503-306-2965
Practice Address - Fax:503-235-0618
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1770103TC0700X
CAPSY16258103TC0700X
WAPY00003389103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical