Provider Demographics
NPI:1023121803
Name:DAHL, SUSAN FRANCES (MSN,CRNFA,BHA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:FRANCES
Last Name:DAHL
Suffix:
Gender:F
Credentials:MSN,CRNFA,BHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 54TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2159
Mailing Address - Country:US
Mailing Address - Phone:206-387-8034
Mailing Address - Fax:206-725-3751
Practice Address - Street 1:3333 N WHITMAN ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-1547
Practice Address - Country:US
Practice Address - Phone:253-759-3065
Practice Address - Fax:253-759-3075
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00054047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUS0864194OtherAETNA SPECIALIST PIN
WA0039573OtherLABOR AND INDUSTRIES #
WADA4429OtherBLUE SHIELD #