Provider Demographics
NPI:1104069087
Name:LOW-BEER, SUSANNA (LAC)
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:LOW-BEER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 NE HOLMAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-5478
Mailing Address - Country:US
Mailing Address - Phone:503-309-5939
Mailing Address - Fax:
Practice Address - Street 1:2003 NE HOLMAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-5478
Practice Address - Country:US
Practice Address - Phone:503-309-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01272171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist