Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP60249845 | WA |
N | 363LC1500X | Nurse Practitioner - Community Health | AP60249845 | WA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60249845 | WA |
NPI | 1932479714 |
---|---|
Provider Name | Susan M Putaansuu |
First Address | Puyallup, WA 98372-3265 |
Second Address | Puyallup, WA 98372-3265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 09/06/2015 |