Provider Demographics
NPI:1285675587
Name:MOURTON, SUSANNAH MAY (MD)
Entity type:Individual
Prefix:DR
First Name:SUSANNAH
Middle Name:MAY
Last Name:MOURTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSANNAH
Other - Middle Name:MAY
Other - Last Name:BEEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-0421
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:509-227-7070
Practice Address - Street 1:101 W 8TH AVE STE 1400
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2307
Practice Address - Country:US
Practice Address - Phone:509-474-2200
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60436192207VX0201X
CAA83315207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8928964Medicare PIN