Individual provider Active NPI

Susan Mitchell, FNP

  • Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1740502616
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60472276 Issued in WA
Practice address
406 SE 131St Ave Ste 104
Vancouver, WA 98683-4031
Phone
(877) 522-1275
Fax
(833) 888-7145
NPI assigned
Feb 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201150112NP OR
Nurse Practitioner 363L00000X AP60472276 WA Primary

Addresses

Primary practice location

406 SE 131St Ave Ste 104
Vancouver, WA 98683-4031

Mailing address

500 SW 7TH St Ste A205
Renton, WA 98057-2983
Phone (509) 222-1275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, ID, NM4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20111102000353 OR Practitioner - Nurse Practitioner 1153459458 Reassigns benefits to 3 organizations
I20140829001546 WA Practitioner - Nurse Practitioner 1153459458 Reassigns benefits to 2 organizations
I20240318003041 ID Practitioner - Nurse Practitioner 1153459458 Reassigns benefits to 2 organizations
I20250217000018 NM Practitioner - Nurse Practitioner 1153459458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ideal Telemedicine Services LLCGroup PAC ID 2860726221, 47 clinicians
Ideal Option PLLCGroup PAC ID 6709013105, 90 clinicians

Practice addresses (Care Compare)

1318 NW 9TH St
Suite B
Corvallis, OR 97330-4565
Phone (877) 522-1275

1630 23Rd Ave
Suite 501
Lewiston, ID 83501-6345
Phone (509) 570-9302

406 SE 131St Ave
Suite 104
Vancouver, WA 98683-4031
Phone (509) 222-1275

532 N Telshor Blvd
Suite G
Las Cruces, NM 88011-8234
Phone (877) 522-1275

532 N Telshor Blvd G
Ideal Option PLLC
Las Cruces, NM 88011-8234
Phone 87752212752123

545 SE Oak St
Suite D
Hillsboro, OR 97123-4147
Phone 87752212753049

8508 W Gage Blvd
Suite A101
Kennewick, WA 99336-8106
Phone 50957093022123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60472276WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Option, PLLC Current Accepting new patients
Ideal Option, PLLC CurrentSince Jul 26, 2019 Accepting new patients
Ideal Telemedicine Services, LLC CurrentSince Jul 26, 2019 Accepting new patients
Ideal Option, PLLC Current Accepting new patients
Ideal Telemedicine Services, LLC Past Accepting new patients

Locations (25 of 40)

3110 Cleveland Blvd
Bldg A
Caldwell, ID 83605

3110 Cleveland Blvd
Ste A7
Caldwell, ID 83605

3918 N Schreiber Way
Coeur D Alene, ID 83815
Phone (509) 961-6672

1630 23rd Ave
Ste 501
Lewiston, ID 83501

801 Encino Pl NE
Ste E6
Albuquerque, NM 87102
Phone (505) 299-4414

532 N Telshor Blvd
Ste G
Las Cruces, NM 88011
Phone (505) 373-8415

3301 Southern Blvd SE
Ste 105
Rio Rancho, NM 87124
Phone (505) 270-0840

404 NE Penn Ave
Bend, OR 97701
Phone (541) 318-7041

1318 NW 9th St
Ste B
Corvallis, OR 97330

401 E 10th Ave
Ste 330
Eugene, OR 97401
Phone (541) 344-6929

545 SE Oak St
Ste D
Hillsboro, OR 97123
Phone (503) 640-1614

158 W Olive St
Newport, OR 97365
Phone (541) 248-2634

863 Liberty St NE
Salem, OR 97301
Phone (503) 399-5597

16410 Smokey Point Blvd
Ste 101
Arlington, WA 98223
Phone (360) 653-8711

1811 Howard Rd
Ste 101
Auburn, WA 98002

1215 120th Ave NE
Ste 201
Bellevue, WA 98005
Phone (425) 248-4200

3800 Byron Ave
Ste 122
Bellingham, WA 98229

3800 Byron Ave
Ste 116
Bellingham, WA 98229
Phone (509) 416-0253

7315 212th St SW
Ste 201
Edmonds, WA 98026
Phone (425) 778-8116

4301 Hoyt Ave
Everett, WA 98203
Phone (425) 317-8025

8514 W Gage Blvd
Ste G
Kennewick, WA 99336
Phone 50922212756

8508 W Gage Blvd
Ste A101
Kennewick, WA 99336
Phone 8775221275 ext. 3049

1146 14th Ave
Longview, WA 98632

1617 Grove St
Marysville, WA 98270
Phone (360) 356-6533

101 E Main St
Ste 201
Monroe, WA 98272
Phone (360) 863-0642

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1740502616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SW 7TH ST STE A205",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572983",
            "telephone_number": "509-222-1275",
            "fax_number": "888-833-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834031",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SUSAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201150112NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60472276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.