Provider Demographics
NPI:1780819722
Name:WILHELM, SUSANNE (DO)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:WILHELM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 24TH ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2592
Mailing Address - Country:US
Mailing Address - Phone:360-293-4655
Mailing Address - Fax:360-588-1041
Practice Address - Street 1:1213 24TH ST
Practice Address - Street 2:SUITE #100
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2592
Practice Address - Country:US
Practice Address - Phone:360-293-4655
Practice Address - Fax:360-588-1041
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP60221514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine