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Individual

SUSAN M. EASTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
EAST 115 BROADWAY, REARDAN, WA 99029-0629
(509) 796-2737
(509) 796-2738
Mailing address
100 3RD ST, SUITE 1, DAVENPORT, WA 99122-9730
(509) 725-7501
(509) 725-7504

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00049615
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP30000282
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142721
DEPT. OF L & I
WA
01
500023044
MEDICARE RAILROAD
WA
05
7101132
WA
05
7117450
WA
05
9600123
WA
01
CJ6525
MEDICARE RAILROAD
WA
Enumeration date
06/14/2006
Last updated
03/07/2023
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