Individual provider Active NPI

Susan Anne Krueger, M.A.

  • Specialist
  • Tukwila, WA
National Provider Identifier
1962672253
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
LH00011072 Issued in WA
Practice address
6000 Southcenter Blvd
Ste. #16
Tukwila, WA 98188-7773
Phone
(206) 422-6780
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X LH00011072 WA Primary

Addresses

Primary practice location

6000 Southcenter Blvd
Ste. #16
Tukwila, WA 98188-7773

Mailing address

11716 SE 322ND St
Auburn, WA 98092-4812
Phone (206) 422-6780

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LH00011072WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1962672253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11716 SE 322ND ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980924812",
            "telephone_number": "206-422-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 SOUTHCENTER BLVD",
            "address_2": "STE. #16",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981887773",
            "telephone_number": "206-422-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "SUSAN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "LH00011072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.