Mahoney, Susan Marie

Mahoney, Susan Marie is an individual health care provider with primary practice located at 1117 Spring St , Friday Harbor WA 98250-8057. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mahoney, Susan Marie can be contacted via phone (360) 378-2141.

Contact Information

Primary practice address
1117 Spring St Friday Harbor WA 98250-8057
Phone: (360) 378-2141
Fax: (360) 378-3655
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD00034157 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00034157 Washington

Profile Details

NPI number 1295848265
LBN Legal business name Mahoney, Susan Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Feb 4th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295848265 NPPES
Washington Other 1295848265 REGENCY BLUE SHIELD
Washington MEDICAID 1295848265 REGENCY BLUE SHIELD
Washington MEDICAID 8209199 REGENCY BLUE SHIELD
Washington Other 1295848265 REGENCY BLUE SHIELD

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