Individual provider Active NPI

Susan Lynn Marra, ND

  • Naturopath
  • Poulsbo, WA
National Provider Identifier
1679760920
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT00001579 Issued in WA
Practice address
17791 Fjord Drive NE
Ste 130
Poulsbo, WA 98370
Phone
(206) 299-2676
Fax
(206) 522-7410
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X AHC-NAT-LIC-130784 MT
Naturopath 175F00000X NDF-654 CA
Naturopath 175F00000X NT00001579 WA Primary

Addresses

Primary practice location

17791 Fjord Drive NE
Ste 130
Poulsbo, WA 98370

Mailing address

17791 Fjord Drive NE
Ste 130
Poulsbo, WA 98370
Phone (206) 299-2676

Other identifiers 1

IdentifierTypeStateIssuer
NT00001579OtherND LICENSE NUMBER

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
NDF-654CAMDNaturopath
AHC-NAT-LIC-130784MTMDNaturopath
NT00001579WAMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1679760920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17791 FJORD DRIVE NE",
            "address_2": "STE 130",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "206-299-2676",
            "fax_number": "206-522-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17791 FJORD DRIVE NE",
            "address_2": "STE 130",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "206-299-2676",
            "fax_number": "206-522-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRA",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "MT",
            "license": "AHC-NAT-LIC-130784",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "NDF-654",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00001579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND LICENSE NUMBER",
            "identifier": "NT00001579",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.