Chadlyn Renae Susak, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60868656 Issued in WA

Practice address

201 S Water St
Ellensburg, WA 98926-3675

Phone

(509) 962-0533

NPI assigned

Sep 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fred Meyer Stores Inc

  • Community/Retail Pharmacy
  • Ellensburg, WA
  • NPI 1114963659
  NPD (past)
• Fred Meyer Stores Inc.

  • Community/Retail Pharmacy
  • Lynnwood, WA
  • NPI 1558235762
  NPD (past)
• Thome Enterprise L L C

  • Long Term Care Pharmacy
  • Selah, WA
  • NPI 1174616221
  NPD (past)

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1992280770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1253",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989261903",
            "telephone_number": "360-581-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S WATER ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263675",
            "telephone_number": "509-962-0533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 E 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Selah",
            "state": "WA",
            "postal_code": "989421430",
            "country_code": "US",
            "telephone_number": "509-697-6125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 S Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Ellensburg",
            "state": "WA",
            "postal_code": "989263875",
            "country_code": "US",
            "telephone_number": "509-925-8484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSAK",
        "first_name": "CHADLYN",
        "middle_name": "RENAE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60868656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PH60868656",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Patrick Sullivan, DDS
• Margaretanne Hartman Sullivan, DDS
• Krista J Summers, MD
• Summit Speech Therapy of Central Washington, LLC
• Huilin Sun, ARNP
• Jonathan Thomas Suttles, MSPT
• Sheryl Lynne Sutton, MPL
• Spencer T Sutton, DO
• Naomi Swain, DO
• Alexis Swartz, MS, RD

• Pharmacist in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.