Active NPI
Suzan Jeanne Watanabe, ARNP
- Advanced Practice Midwife
- Kirkland, WA
National Provider Identifier
1598845018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- AP 30000483
- Practice address
- 11919 NE 128TH St
Suite C
Kirkland, WA 98034-7204 - Phone
- (425) 899-5600
- Fax
- (425) 899-5603
- NPI assigned
- Oct 17, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | AP 30000483 | WA | |
| Advanced Practice Midwife | 367A00000X | AP 30000483 | WA | Primary |
Addresses
Primary practice location
11919 NE 128TH St
Suite C
Kirkland, WA 98034-7204
Mailing address
11919 NE 128TH St
Suite C
Kirkland, WA 98034-7204
Phone (425) 899-5600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9606690 | Medicaid | WA | |
| WA3359 | Other | WA | REGENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090424000236 | WA | Practitioner - Nurse Practitioner | 8123176427 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4020 | WA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| AP 30000483 | WA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1598845018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11919 NE 128TH ST",
"address_2": "SUITE C",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980347204",
"telephone_number": "425-899-5600",
"fax_number": "425-899-5603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11919 NE 128TH ST",
"address_2": "SUITE C",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980347204",
"telephone_number": "425-899-5600",
"fax_number": "425-899-5603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATANABE",
"first_name": "SUZAN",
"middle_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "WA",
"license": "AP 30000483",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "WA",
"license": "AP 30000483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9606690",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "WA3359",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.