SUSAN LEE SHANE (NPI# 1366456832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366456832 |
| Entity Type | Individual |
| Full Name | SUSAN LEE SHANE |
| Credential | ARNP |
| Practice Address |
390 Founders Way Suite 1 Forks WA 98331-9062 |
| Mailing Address |
Po Box 153 411 Calawah Forks WA 98331-0153 |
| Practice Telephone | 3603749180 |
| Practice Fax Number | 3603743162 |
| Mailing Telephone | 3603749180 |
| Mailing Fax Number | 3603743162 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2011-06-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WW0101X |
Registered Nurse Specialization: Women's Health Care, Ambulatory |
RN00050684 | WA | Nursing Service Providers |
| Y | 364SW0102X |
Clinical Nurse Specialist Specialization: Women's Health |
AP30000331 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9607458 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811959927 | Susan P. Shane | Family Medicine | 1 South Prospect Street, Fahc Family Medicine, Arnold 4, Burlington, VT 05401 | 2006-04-04 |
| 1184726861 | Susan Shane | Social Worker | 1000 N Oak Ave, Marshfield, WI 54449 | 2006-09-02 |
| Street Address |
390 FOUNDERS WAY SUITE 1 |
| City | FORKS |
| State | WA |
| Zip Code | 98331-9062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285683052 | Clallam County Public Hospital District No1 | Clinic/Center | 390 Founders Way, Forks, WA 98331-9062 | 2006-05-09 |
| 1801350673 | Stephanie Marie Bechtold | Nurse Practitioner | 390 Founders Way, Forks, WA 98331-9062 | 2019-01-25 |
| 1285861989 | Shannon L. Servin-obert | Family Medicine | 390 Founders Way, Forks, WA 98331-9062 | 2009-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518509520 | Sasha Rose Jensen | Nurse Practitioner | 460 West G Street, Forks, WA 98331 | 2019-10-10 |
| 1497298046 | Cathy A. Clark L.m.p. | Massage Therapist | 186-375 Hwy. 101, Forks, WA 98331 | 2016-11-30 |
| 1841447752 | Concerned Citizens | Early Intervention Provider Agency | 945 S Forks Ave, Forks, WA 98331 | 2008-08-21 |
| 1720276207 | Richard L. Dickson | Clinic/Center | 481 West E St, Forks, WA 98331 | 2007-10-09 |
| 1508078627 | John M Shima Md Ps | Internal Medicine | 460 West E St, Forks, WA 98331 | 2007-05-03 |
| 1578612875 | Anea Beck Ownes | Massage Therapist | 230 Willow Ave, Forks, WA 98331 | 2007-01-09 |
| 1295820173 | Howard Edward Berris | Dentist | 37325 W 12 Mile Rd, Suite B, Farmington Hills, MI 98331 | 2006-10-04 |
| 1760455075 | Richard Lee Dickson | Family Medicine | 481 W E St, Forks, WA 98331 | 2006-02-08 |
| 1700382843 | Vernon Rondeau | Registered Nurse | 560 Quileute Heights, La Push, WA 98331 | 2018-04-05 |
| 1962769760 | Anand Selvam | Emergency Medicine | 530 Bogachiel Way, Forks, WA 98331 | 2012-04-18 |
| Find all providers in zip 98331 | ||||
| Taxonomy Code | 364SW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003271057 | Love The Belly Midwifery & Women's Health, LLC | Clinical Nurse Specialist | 5224 Olympic Dr Nw Ste 106, Gig Harbor, WA 98335-1792 | 2015-12-17 |
| 1578600060 | Julie R Utter | Clinical Nurse Specialist | 2001 East Madison, Seattle, WA 98122 | 2007-01-31 |
| 1619948338 | Marnie G Schumacher | Clinical Nurse Specialist | 2109 Sumner Ave, Aberdeen, WA 98520-3600 | 2006-01-30 |
| 1205126448 | Tania Tiburcio | Clinical Nurse Specialist | 813 Martin Luther King Jr Way, Tacoma, WA 98405-4147 | 2011-04-08 |
| 1447447388 | Joan Diane Austin | Clinical Nurse Specialist | 1325 4th Ave, Suite 1240, Seattle, WA 98101-2573 | 2007-09-25 |
| 1740370253 | Janice Eileen D'amico | Clinical Nurse Specialist | 900 Ferry St, Wenatchee, WA 98801-3405 | 2006-10-13 |
Please comment or provide details below to improve the information on SUSAN LEE SHANE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.