Individual provider Active NPI

Susan A Passalacqua, NURSE

  • Registered Nurse
  • Everett, WA
National Provider Identifier
1952366544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00087696 Issued in WA
Practice address
2000 W Marine View Dr
Bluilding 2010
Everett, WA 98207-0001
Phone
(425) 304-4122
Fax
(425) 304-4082
NPI assigned
Apr 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00087696 WA Primary
Registered Nurse 163W00000X 399688 CA

Addresses

Primary practice location

2000 W Marine View Dr
Bluilding 2010
Everett, WA 98207-0001

Mailing address

5121 233Rd PL NE
Arlington, WA 98223-7605
Phone (360) 474-0451

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
399688CAMDRegistered Nurse
RN00087696WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952366544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 233RD PL NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237605",
            "telephone_number": "360-474-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W MARINE VIEW DR",
            "address_2": "BLUILDING 2010",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982070001",
            "telephone_number": "425-304-4122",
            "fax_number": "425-304-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSALACQUA",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00087696",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "399688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.