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Individual
SUSAN MARIE MAHONEY
Active
Individual
SUSAN MARIE MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD00034157
WA
207Q00000X
Family Medicine Physician
Primary
MD00034157
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295848265
REGENCY BLUE SHIELD
WA
05
—
1295848265
—
WA
05
—
8209199
—
WA
Enumeration date
08/16/2006
Last updated
02/04/2013
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