Individual provider Active NPI

Susan Beth Guerin, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, OR
National Provider Identifier
1417040387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD14017 Issued in OR
Practice address
13705 NE Airport Way
Suite C
Portland, OR 97230-1048
Phone
(503) 258-6855
Fax
(503) 258-6864
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD14017 OR Primary

Addresses

Primary practice location

13705 NE Airport Way
Suite C
Portland, OR 97230-1048

Mailing address

11755 SE Idleman Rd
Portland, OR 97266-6860
Phone (503) 771-8361

Other names 1

  • Susan Beth Barrar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417040387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11755 SE IDLEMAN RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666860",
            "telephone_number": "503-771-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13705 NE AIRPORT WAY",
            "address_2": "SUITE C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301048",
            "telephone_number": "503-258-6855",
            "fax_number": "503-258-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERIN",
        "first_name": "SUSAN",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD14017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BARRAR",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.