Active NPI
Susan Marie Orchard, M.D.
- Dermatology Physician
- Camas, WA
National Provider Identifier
1215919386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 025209 MD00032503
- Practice address
- 1307 NE 194TH Ave (Home Address and Phone)
Camas, WA 98607-9256 - Phone
- (360) 944-9964
- NPI assigned
- Nov 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 025209 MD00032503 | WA | Primary |
Addresses
Primary practice location
1307 NE 194TH Ave (Home Address and Phone)
Camas, WA 98607-9256
Mailing address
1307 NE 194TH Ave (Home Address and Phone)
Camas, WA 98607-9256
Phone (360) 944-9964
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025209 MD00032503 | WA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294012800000",
"number": "1215919386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 NE 194TH AVE (HOME ADDRESS AND PHONE)",
"city": "CAMAS",
"state": "WA",
"postal_code": "986079256",
"telephone_number": "360-944-9964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 NE 194TH AVE (HOME ADDRESS AND PHONE)",
"city": "CAMAS",
"state": "WA",
"postal_code": "986079256",
"telephone_number": "360-944-9964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORCHARD",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-15",
"last_updated": "2011-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "025209 MD00032503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camas, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.