MEDICARE: SUSAN WASHINGTON RN

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
1	163W00000X	Registered Nurse	00165566	WA

General Provider Information

NPI Number	:	1467935676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN WASHINGTON RN

Provider Business Mailing Address
First Line	:	4103 FRANCIS AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7730
Country	:	US
Telephone Number	:	206-632-7533
Fax Number	:

Provider Business Practice Location Address
First Line	:	4103 FRANCIS AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7730
Country	:	US
Telephone Number	:	206-632-7533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	09/13/2018

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