Provider Demographics
NPI:1831236033
Name:HAKEMAN, SUSAN M (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:HAKEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1112 11TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6654
Mailing Address - Country:US
Mailing Address - Phone:360-671-1701
Mailing Address - Fax:360-756-8850
Practice Address - Street 1:1112 11TH ST STE 301
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6654
Practice Address - Country:US
Practice Address - Phone:360-671-1701
Practice Address - Fax:360-756-8850
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA320432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1982HAOtherREGENCE
WA1982HAOtherREGENCE
WAF89370Medicare UPIN