Susan Renee Correll, RN

Individual provider Active NPI Emergency Registered Nurse · Deer Park, WA

NPI 1053252015 · NPPES record last updated Apr 3, 2026

Key facts

NPI
1053252015
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
RN00103483 (WA)
Practice address
6615 Saddle Mountain Way
Deer Park, WA 99006-6052
Phone
(509) 999-4902
NPI assigned
Apr 3, 2026
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00103483WAMDEmergency Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN00103483 WA Yes

Addresses

Primary practice location

6615 Saddle Mountain Way
Deer Park, WA 99006-6052

Mailing address

6615 Saddle Mountain Way
Deer Park, WA 99006-6052
Phone (509) 999-4902

Other providers in Deer Park, WA

All providers in Deer Park, WA · Emergency Registered Nurse in Washington

Sources for this page

Verify at the official NPI Registry.