Individual provider Active NPI

Susan McLean, RD

  • Registered Dietitian
  • Tacoma, WA
National Provider Identifier
1104853357
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
353334 Issued in WA
Practice address
Puget Sound Health Care System a-119-NFS
9600 Veterans Dr
Tacoma, WA 98493-0003
Phone
(253) 583-2364
Fax
(253) 589-4126
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 353334 WA Primary

Addresses

Primary practice location

Puget Sound Health Care System a-119-NFS
9600 Veterans Dr
Tacoma, WA 98493-0003

Mailing address

15112 14TH Ave NW
Gig Harbor, WA 98332-9703
Phone (253) 857-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
353334WAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104853357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15112 14TH AVE NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983329703",
            "telephone_number": "253-857-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PUGET SOUND HEALTH CARE SYSTEM A-119-NFS",
            "address_2": "9600 VETERANS DR",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930003",
            "telephone_number": "253-583-2364",
            "fax_number": "253-589-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "SUSAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "353334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.