Healthcare Provider Details

I. General information

NPI: 1750321469
Provider Name (Legal Business Name): SUSAN W FEENEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 N 5TH AVE
SEQUIM WA
98382-3045
US

IV. Provider business mailing address

PO BOX 850
PORT ANGELES WA
98362-0146
US

V. Phone/Fax

Practice location:
  • Phone: 360-683-9895
  • Fax: 360-582-5614
Mailing address:
  • Phone: 360-565-9237
  • Fax: 360-417-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35087937
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number01063688A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number15355
License Number StateWY
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number40642
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD61289770
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier200827320
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer
# 2
Identifier64118524
Identifier TypeMEDICAID
Identifier StateKY
Identifier Issuer
# 3
Identifier2656362
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer
# 4
IdentifierP00411791
Identifier TypeOTHER
Identifier StateKY
Identifier IssuerMEDICARE RAILROAD
# 5
IdentifierP00969062
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerMEDICARE RAILROAD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: