Provider Demographics
NPI:1053467407
Name:KARLSEN, SUSAN PATRICIA (LMP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:PATRICIA
Last Name:KARLSEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:PATRICIA
Other - Last Name:KARLSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:2411 NW 195TH PL
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2931
Mailing Address - Country:US
Mailing Address - Phone:206-396-6359
Mailing Address - Fax:
Practice Address - Street 1:2411 NW 195TH PL
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-2931
Practice Address - Country:US
Practice Address - Phone:206-396-6359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor