DR. SUSAN ELISE KOCH (NPI# 1912092693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912092693 |
| Entity Type | Individual |
| Full Name | DR. SUSAN ELISE KOCH |
| Other Name | DR. SUSAN ELISE JAHNKE |
| Credential | M.D. |
| Practice Address |
9900 Se Sunnyside Rd Clackamas OR 97015-9750 |
| Mailing Address |
20200 Se Walgren Rd Damascus OR 97089 |
| Practice Telephone | 5036536440 |
| Practice Fax Number | 5035718974 |
| Mailing Telephone | 5036587218 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | MD00037941 | WA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | MD21378 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548590482 | Susan Hatfield Koch | Psychiatry & Neurology | 456 Frontage Rd, Suite 28, Northfield, IL 60093-3034 | 2009-12-27 |
| 1437262607 | Susan C Koch | Speech-Language Pathologist | 7146 S Braden Ave Ste 500, Tulsa, OK 74136-6376 | 2006-08-15 |
| 1760762967 | Susan Wenonah Koch | Genetic Counselor, MS | 1201 S Collegeville Rd, Collegeville, PA 19426-2998 | 2011-08-19 |
| 1629211164 | Susan Koch | Physical Therapist | 600 Central Ave, Suite 305, Highland Park, IL 60035-3211 | 2009-04-14 |
| 1215096342 | Susan Harriett Koch | Physical Therapist | 27401 W Il Route 22, Suite 107, Barrington, IL 60010-5999 | 2006-12-06 |
| 1902868573 | Susan Koch | Midwife | 420 S 5th Ave, West Reading, PA 19611-2143 | 2006-04-06 |
| Street Address |
9900 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-9750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982675690 | Tony S Clinton | Dermatology | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2006-01-30 |
| 1700395811 | Jeffrey Ha Nguyen | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2017-09-21 |
| 1255850434 | Taylor Martin | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2017-09-19 |
| 1386189595 | Darin Ferry | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-12-23 |
| 1720530058 | Kaiser Foundation Health Plan of The Northwest | General Practice | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-11-03 |
| 1912458944 | Kimberly Brownell | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-10-14 |
| 1487104956 | Sze Wing Ngan | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-10-10 |
| 1740738327 | Frederick R Engelmann | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-09-13 |
| 1215483680 | Clifford Stephens | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-08-26 |
| 1235594896 | Celeste Richardson | Physician Assistant | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2015-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073879128 | Una Clare Miniter | Dermatology | 10151 Se Sunnyside Rd Ste 240, Clackamas, OR 97015 | 2012-04-03 |
| 1255569273 | Paul Jeffrey Aanderud | Dermatology | 9775 Se Sunnyside Rd Ste 500, Clackamas, OR 97015-5724 | 2009-06-29 |
| 1982675690 | Tony S Clinton | Dermatology | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2006-01-30 |
| 1225017288 | Peter E Goodkin | Dermatology | 9775 Se Sunnyside Road, Suite 500, Clackamas, OR 97015-5724 | 2006-01-10 |
| 1538592399 | Zachary G Pena | Dermatology | 10151 Se Sunnyside Rd Ste 240, Clackamas, OR 97015-5774 | 2013-08-15 |
| 1700221397 | Clackamas Dermatology PC | Dermatology | 9775 Se Sunnyside Rd, #500, Clackamas, OR 97015-5739 | 2013-05-08 |
| 1013142116 | Jo M Martin | Dermatology | 9900 Se Sunnyside Rd, Nw Permanente PC, Physicians and Surgeons, Clackamas, OR 97015-9777 | 2009-05-19 |
| 1396941530 | Peter E. Goodkin, M.d., P.C. | Dermatology | 9775 Se Sunnyside Rd, Suite 500, Clackamas, OR 97015-5739 | 2007-06-25 |
| 1700928397 | Travis James Widman | Dermatology | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2007-02-12 |
| 1386732923 | Matthew G Basco | Dermatology | 9800 Se Sunnyside Rd, Mt Scott Medical Office, Clackamas, OR 97015-9750 | 2006-10-10 |
| Find all providers in CLACKAMAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.