Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD00042745 | WA |
N | 208600000X | Surgeon | MD00042745 | WA |
Y | 2086S0129X | Vascular Surgeon | MD00042745 | WA |
NPI | 1164420261 |
---|---|
Provider Name | Susan Laurie Morrison |
First Address | Vancouver, WA 98683-9324 |
Second Address | Longview, WA 98632-2367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 08/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0217052 | LABOR & IND (01) | WA |
022615 | (05) | OR |
8377178 | (05) | WA |
8943479 | CRIME VICTIMS (01) | WA |
H44224 | (02) | WA |
P00392953 | RAILROAD MEDICARE (01) |