Individual
SUSAN WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
888 SWIFT BLVD, RICHLAND, WA 99352-3514
(509) 946-4611
(253) 838-6418
Mailing address
203 S WESTERN AVE, TONASKET, WA 98855-8803
(509) 486-3144
(509) 486-3176
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP00001172
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202707
LIWA
WA
05
—
1048529
—
WA
01
—
3075WH
BSWA
WA
Enumeration date
06/06/2006
Last updated
12/02/2020
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