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NPI Code Detail

MEDICARE: SUSAN LAURIE MORRISON M.D.

MEDICARE: SUSAN LAURIE MORRISON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0129XVascular Surgery PhysicianMD00042745WA
2208600000XSurgery PhysicianMD00042745WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00392953OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30217052OTHERWALABOR & IND
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
58943479OTHERWACRIME VICTIMS

General Provider Information

NPI Number : 1164420261
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LAURIE MORRISON M.D.
Provider Business Mailing Address
First Line : 1115 SE 164TH AVE
Second Line : DEPT. 358
City : VANCOUVER
State : WA
Zip : 98683-9324
Country : US
Telephone Number : 360-729-1462
Fax Number : 360-729-3104
Provider Business Practice Location Address
First Line : 1615 DELAWARE ST
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2367
Country : US
Telephone Number : 360-501-3500
Fax Number : 360-501-3555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 12/08/2016

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Directions to “ SUSAN LAURIE MORRISON M.D.” Practice Location

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