Individual
SUSAN BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 E 8TH ST, PORT ANGELES, WA 98362-6129
(360) 457-0431
(360) 457-0493
Mailing address
118 E 8TH ST, PORT ANGELES, WA 98362-6129
(360) 457-0431
(360) 457-0493
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30003806
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9618661
—
WA
Enumeration date
03/01/2007
Last updated
07/09/2007
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