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1194968172
SUZAN DIANE KINGMA
CLACKAMAS, OR
NPI
1194968172
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L3709)
Enumeration Date
2009-04-07
Last Update Date
2009-04-07
Business Address
Ms. SUZAN DIANE KINGMA LCSW
9800 SE SUNNYSIDE RD
CLACKAMAS, OR 97015-9750
Phone number: 503-652-2880
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Mailing Address
Ms. SUZAN DIANE KINGMA LCSW
9583 SE DENALI DR
HAPPY VALLEY, OR 97086-7307
Phone number: 503-954-2904
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