Individual
SUSAN M SEGEBARTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 SE STONEMILL DR STE 228, VANCOUVER, WA 98684-6987
(360) 687-6650
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10257
MN
363A00000X
Physician Assistant
2082
CO
363A00000X
Physician Assistant
PA166690
OR
363A00000X
Physician Assistant
Primary
PA60217463
WA
363AM0700X
Medical Physician Assistant
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99635844
—
CO
Enumeration date
03/09/2006
Last updated
04/20/2022
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