Individual provider Active NPI

Susan E Holt, PAC

  • Allergy & Immunology Physician
  • Seattle, WA
National Provider Identifier
1720051618
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
PA10001006 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-6600
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X PA10001006 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

1100 Olive Way
Ms: M4-PA
Seattle, WA 98101-1873
Phone (206) 515-5811

Other identifiers 6

IdentifierTypeStateIssuer
US0862204OtherWAAETNA SPECIALIST PIN
069741009OtherWAINDIVIDAUL GROUP HEALTH
8368136MedicaidWA
0039583OtherWAL & I
3331HOOtherWAINDIVIDUAL BLUE SHIELD
970015908OtherWARAILROAD MEDICARE

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10001006WAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center- Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients

Locations

33501 1st Way S
Federal Way, WA 98003
Phone (253) 838-2400

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

1100 Olive Way
#M4
Seattle, WA 98101

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

Interoperability endpoints

  • Direct secure messaging: susan.holt@direct.vmmc.org

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1720051618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OLIVE WAY",
            "address_2": "MS: M4-PA",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011873",
            "telephone_number": "206-515-5811",
            "fax_number": "206-515-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WA",
            "license": "PA10001006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US0862204",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDAUL GROUP HEALTH",
            "identifier": "069741009",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8368136",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0039583",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BLUE SHIELD",
            "identifier": "3331HO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970015908",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.