Active NPI
Susana E Myers, DO
- Pediatrics Physician
- Mukilteo, WA
National Provider Identifier
1710164439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OP60146176
- Practice address
- 4430 106TH St SW
Mukilteo, WA 98275-4711 - Phone
- (425) 493-6000
- NPI assigned
- Jan 24, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | OP60146176 | WA | Primary |
Addresses
Primary practice location
4430 106TH St SW
Mukilteo, WA 98275-4711
Mailing address
7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2008112 | Medicaid | WA |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP60146176 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Washington PLLC | Pediatrics | Current | Accepting new patients |
| Optum Care Washington PLLC | Pediatrics | Current | Accepting new patients |
| Optum Care Washington PLLC | Past | Accepting new patients |
Locations
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
7205 265th St NW
Stanwood, WA 98292
Phone (360) 629-1100
Interoperability endpoints
- smyers13026@direct.tecmc.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
Pediatrics
-
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1154318103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1710164439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7600 EVERGREEN WAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982036421",
"telephone_number": "206-860-5414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4430 106TH ST SW",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "982754711",
"telephone_number": "425-493-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "SUSANA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-24",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "OP60146176",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2008112",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mukilteo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.