Suellen Young, R.N.

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

078041686RN Issued in OR

Practice address

4540 NE Glisan St
Portland, OR 97213-2333

Phone

(503) 215-3738

Fax

(503) 215-6942

NPI assigned

Oct 18, 2012

Last updated

Oct 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health System Oregon

  dba Providence Elder Place Portland

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1023098118
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1093068710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "503-215-3738",
            "fax_number": "503-215-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132333",
            "telephone_number": "503-215-3738",
            "fax_number": "503-215-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SUELLEN",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "078041686RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Young, M.D.
• Shannon N Young
• Shyanne Young
• Stacy L Young, L.C.S.W.
• Stephen C Young, MS, QMHP
• Tim Young
• Whitney Hanna Young, LMHC, LPC
• Yvonne Young
• Jennifer Youngberg, LPC
• Adam Leo Keith Youngblood, PHARMD

• Community Health Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Community Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.