Individual provider Active NPI

Susan Reeder

  • Specialist
  • Portland, OR
National Provider Identifier
1790983757
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
022512 Issued in OR
Practice address
10535 NE Glisan St Ste 350
Portland, OR 97220-4076
Phone
(503) 408-1323
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 022512 OR Primary

Addresses

Primary practice location

10535 NE Glisan St Ste 350
Portland, OR 97220-4076

Mailing address

10218 NE 74TH St
Vancouver, WA 98662-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, AK, WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040622000838 OR Practitioner - Qualified Audiologist 0446235659 Reassigns benefits to 2 organizations
I20090121000179 AK Practitioner - Qualified Audiologist 0446235659 Reassigns benefits to 1 organization
I20180808000890 WA Practitioner - Qualified Audiologist 0446235659 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians
Ear Nose and Throat Associates Southwest Inc PSGroup PAC ID 5294633400, 6 clinicians
Northland Audiology and Hearing Serv IncGroup PAC ID 1456429646, 5 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1130 NW 22ND Ave
Suite 400
Portland, OR 97210-2971
Phone (503) 413-6722

128 Lilly Rd NE
Suite 202
Olympia, WA 98506-7400
Phone (360) 357-6314

8800 Glacier Hwy
Suite 116
Juneau, AK 99801-8079
Phone (907) 789-6780

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022512ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Medford Ear Nose and Throat Clinic PC CurrentSince Nov 22, 2021 Accepting new patients
Entoffice.Org, PLLC CurrentSince Aug 1, 2018 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Oct 6, 2017 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Apr 19, 2023 Accepting new patients
Ear Nose and Throat Associates Southwest Inc PS CurrentSince Apr 1, 2024 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Apr 19, 2023 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Oct 6, 2017 Accepting new patients
Ear Nose and Throat Associates Southwest Inc PS Specialist Current Accepting new patients
Ear Nose and Throat Associates PLLC CurrentSince Mar 1, 2023 Accepting new patients
Suzanne Cleland Zamudio MD PC Past Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients
Portland Ear Nose & Throat Past Accepting new patients

Locations

1170 Royal Ave
Medford, OR 97504
Phone (541) 512-4771

1040 NW 22nd Ave
Ste 168
Portland, OR 97210
Phone (503) 413-7022

1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

128 Lilly Rd NE
Ste 202
Olympia, WA 98506
Phone (360) 357-6314

2621 NE 134th St
Ste 300
Vancouver, WA 98686
Phone (360) 718-2355

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

2121 NE 139th St
Ste 245
Vancouver, WA 98686
Phone (360) 326-3966

Organizations & group practices 14

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

View all 14

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1790983757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10218 NE 74TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204076",
            "telephone_number": "503-408-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "022512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.