Individual
SUSAN PANCOAST NELSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 226-3300
Mailing address
1100 OLIVE WAY, MS: M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00027975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039515
L&I
WA
01
—
5531NE
INDIVIDUAL BLUE SHIELD
WA
05
—
8318123
—
WA
Enumeration date
02/15/2006
Last updated
07/08/2007
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