Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD60436192 | WA |
NPI | 1285675587 |
---|---|
Provider Name | Dr. Susannah May Mourton |
First Address | Spokane, WA 99210-0421 |
Second Address | Spokane, WA 99204-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 18/06/2021 |