Individual
DR. SUSAN S. ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, GCNS-BC, PMHNP
Contact information
Practice address
PO BOX 873473, VANCOUVER, WA 98687-3473
(971) 258-0854
Mailing address
PO BOX 873473, VANCOUVER, WA 98687-3473
(971) 258-0854
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
200850041NP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60031978
WA
364SG0600X
Gerontology Clinical Nurse Specialist
200470003
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8878364
MEDICARE
WA
Enumeration date
06/26/2006
Last updated
05/02/2025
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