Active NPI
Susan A Passalacqua, NURSE
- Registered Nurse
- Everett, WA
National Provider Identifier
1952366544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN00087696
- 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, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 399688 | CA | MD | Registered Nurse |
| RN00087696 | WA | MD | Registered 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.