Provider Demographics
NPI:1972359578
Name:MORGAN, SUSAN (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9709 NE 104TH WAY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-1453
Mailing Address - Country:US
Mailing Address - Phone:360-521-9388
Mailing Address - Fax:
Practice Address - Street 1:11611 NE AINSWORTH CIR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-9017
Practice Address - Country:US
Practice Address - Phone:503-793-9915
Practice Address - Fax:503-257-1779
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR080045729RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management