Rose, Susan S.

Rose, Susan S. is an individual health care provider with primary practice located at Legacy Salmon Creek Providers 2211 Ne 139Th Street, Vancouver WA 98686-2742. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Rose, Susan S. can be contacted via phone (503) 413-8407.

Contact Information

Primary practice address
Legacy Salmon Creek Providers 2211 Ne 139Th Street Vancouver WA 98686-2742
Phone: (503) 413-8407
Fax: (503) 413-6951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 200850041NP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X 200470003 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP60031978 Washington

Profile Details

NPI number 1750318788
LBN Legal business name Rose, Susan S.
Credentials PHD, GCNS-BC, PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jul 23rd, 2020 - about 5 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 1750318788 NPPES
Washington Other G8878364 MEDICARE

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