Individual
SUSAN A DERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
413 LILLY RD NE, MSDDH09, OLYMPIA, WA 98506-5133
(360) 918-0119
Mailing address
PO BOX 5007, LACEY, WA 98509-5007
(360) 918-0119
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
8161176
ID
207P00000X
Emergency Medicine Physician
Primary
MD60547005
WA
Other
Enumeration date
09/27/2006
Last updated
10/11/2024
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