Active NPI
Susan E Detweiler, MD
- Clinical Pathology/Laboratory Medicine Physician
- Seattle, WA
National Provider Identifier
1922027242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- MD00014967
- Practice address
- 1959 NE Pacific St
Seattle, WA 98195-0001 - Phone
- (206) 520-5307
- NPI assigned
- Jul 18, 2006
- 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 |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | MD00014967 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St
Seattle, WA 98195-0001
Mailing address
PO Box 50095
Seattle, WA 98145-5095
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0247886 | Other | WA | LABOR & INDUSTRY |
| 8270605 | Medicaid | WA | |
| MD967WA | Other | WA | ALASKA MEDICAID |
| US0861500 | Other | WA | AETNA/USHC SPECIALIST |
| PA6985 | Other | WA | BLUE SHIELD |
| 220024123 | Other | RAILROAD 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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1922027242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50095",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981455095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950001",
"telephone_number": "206-520-5307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETWEILER",
"first_name": "SUSAN",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "WA",
"license": "MD00014967",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0247886",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8270605",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALASKA MEDICAID",
"identifier": "MD967WA",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC SPECIALIST",
"identifier": "US0861500",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "PA6985",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "220024123",
"state": null
}
],
"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 Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.