Provider Demographics
NPI:1033227863
Name:CAIN, SUSAN SCOTT (ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:SCOTT
Last Name:CAIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E TRENT AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2902
Mailing Address - Country:US
Mailing Address - Phone:509-747-3147
Mailing Address - Fax:
Practice Address - Street 1:1401 E TRENT AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2902
Practice Address - Country:US
Practice Address - Phone:509-747-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005667363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9628991Medicaid
WA500027610OtherRRB
WA141899OtherL&I
WA141899OtherL&I
WA500027610OtherRRB