Provider Demographics
NPI:1588684716
Name:MARNEY, SUSAN C (ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:MARNEY
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 1:145 S WORTHEN ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3081
Mailing Address - Country:US
Mailing Address - Phone:509-662-6761
Mailing Address - Fax:509-662-3182
Practice Address - Street 1:145 S WORTHEN ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3081
Practice Address - Country:US
Practice Address - Phone:509-662-6761
Practice Address - Fax:509-662-3182
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004037363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA126913OtherL&I
WA9640285Medicaid
WA9640285Medicaid
WA000316156Medicare ID - Type Unspecified
WAG8920008Medicare PIN