Active NPI
Susan L. Willard, ARNP
- Nurse Practitioner
- Seattle, WA
National Provider Identifier
1912925025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30005527
- Practice address
- 1100 9TH Ave
Seattle, WA 98101-2756 - Phone
- (206) 341-0060
- Fax
- (206) 625-7245
- NPI assigned
- Jul 17, 2006
- Last updated
- Feb 12, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30005527 | WA | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | AP30005527 | WA | |
| Registered Nurse | 163W00000X | RN00133454 | WA |
Addresses
Primary practice location
1100 9TH Ave
Seattle, WA 98101-2756
Mailing address
1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 341-0060
Other practice location 1
1959 NE Pacific St
Box 356165
Seattle, WA 98195-0001
Phone (206) 598-4532
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0177835 | Other | WA | LABOR & INDUSTRY |
| 9639667 | Medicaid | WA |
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
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518393600000",
"number": "1912925025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-341-0060",
"fax_number": "206-625-7245"
},
{
"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": "206-341-0060",
"fax_number": "206-625-7245"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St",
"address_2": "Box 356165",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981950001",
"country_code": "US",
"telephone_number": "206-598-4532",
"fax_number": "206-598-4477",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLARD",
"first_name": "SUSAN",
"middle_name": "L.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2018-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30005527",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WA",
"license": "AP30005527",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00133454",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0177835",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9639667",
"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 Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.