Provider Demographics
NPI:1891758025
Name:SAUSER, DONALD DUANE (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:DUANE
Last Name:SAUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13215 SE MILL PLAIN BLVD
Mailing Address - Street 2:STE C8-901
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6963
Mailing Address - Country:US
Mailing Address - Phone:360-882-6929
Mailing Address - Fax:360-882-6929
Practice Address - Street 1:400 NE MOTHER JOSEPH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3200
Practice Address - Country:US
Practice Address - Phone:360-256-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000444402085R0202X
OR174782085R0202X
CAG240022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8133696Medicaid
OR032081Medicaid
WAP00242558OtherRR MEDICARE
ID003937700Medicaid
CAA42125Medicare UPIN
WA8133696Medicaid
WAP00242558OtherRR MEDICARE
ORA42125Medicare UPIN