Susan Christa Bosman
Individual provider Active NPI Addiction (Substance Use Disorder) Registered Nurse · Chehalis, WA
NPI 1003486598 · NPPES record last updated Jun 28, 2021
Key facts
- NPI
- 1003486598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse 163WA0400X
- License
- RN00124390 (WA)
- Practice address
- 500 SE Washington Ave.
Optional
Chehalis, WA 98532 - Phone
- (360) 507-8032
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00124390 | WA | MD | Addiction (Substance Use Disorder) Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | RN00124390 | WA | Yes |
Addresses
Primary practice location
500 SE Washington Ave.
Optional
Chehalis, WA 98532
Mailing address
500 SE Washington Ave.
Optional
Chehalis, WA 98532
Phone (360) 507-8032
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077844 | Medicaid | WA |
Other providers in Chehalis, WA
- Charli Loretta Boess
- Krystal Bonds
- Emily Michelle Boniface
- Norma Bonnin
- Carolyn A Borovec
- Donna Lee Bouchard
- Mubanga Bowa
- Marcie M Bowers
- Richard Dean Bowers
- Jason Immanuel Brandis
All providers in Chehalis, WA · Addiction (Substance Use Disorder) Registered Nurse in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.