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NPI Code Detail

MEDICARE: SUSAN MORGAN ROYSTER PAC

MEDICARE: SUSAN MORGAN ROYSTER PAC
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
1363A00000XPhysician AssistantPA10003978WA
2363A00000XPhysician AssistantPA1435ME

General Provider Information

NPI Number : 1255324695
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MORGAN ROYSTER PAC
Provider Business Mailing Address
First Line : 201 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5226
Country : US
Telephone Number : 206-326-3000
Fax Number :
Provider Business Practice Location Address
First Line : 201 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5226
Country : US
Telephone Number : 206-326-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 04/29/2021

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Directions to “ SUSAN MORGAN ROYSTER PAC” Practice Location

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