Individual
SUSAN G WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2075 BARKLEY BLVD, SUITE 105, BELLINGHAM, WA 98226-6614
(360) 671-3345
(360) 650-1354
Mailing address
709 W ORCHARD DR, SUITE #4, BELLINGHAM, WA 98225-1766
(360) 318-8800
(360) 318-1085
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30000325
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128742
L & I (REGULAR)
WA
01
—
0500013378
RAILROAD MEDICARE
WA
01
—
192942512
US DEPT OF LABOR
WA
01
—
25892
REGENCE BLUESHIELD
WA
01
—
423898016
GROUP HEALTH COOPERATIVE
WA
01
—
8925053
L & I (CRIME VICTIM)
WA
05
—
9602970
—
WA
Enumeration date
07/21/2006
Last updated
07/24/2012
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