Susan Lee Shane, ARNP is a
Clinical Nurse Specialist - Women's Health based in Forks, Washington. Susan Lee Shane is licensed to practice in Washington (license number AP30000331) and her current practice location is
390 Founders Way, Suite 1, Forks, Washington. She can be reached at her office (for appointments etc.) via phone at
(360) 374-9180.
NPI number for Susan Lee Shane is 1366456832 and her current mailing address is Po Box 153, 411 Calawah, Forks, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366456832.
Provider's Profile
| Full Name | Susan Lee Shane |
|---|
| Gender | Female |
|---|
| Speciality | Clinical Nurse Specialist - Women's Health |
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| Location | 390 Founders Way, Forks, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1366456832
- Provider Enumeration Date: 07/28/2006
- Last Update Date: 06/29/2011
Medical Identifiers
Medical identifiers for Susan Lee Shane such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366456832 | NPI | - | NPPES |
| 9607458 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163WW0101X | Registered Nurse - Women's Health Care, Ambulatory | RN00050684 (Washington) | Secondary |
| 364SW0102X | Clinical Nurse Specialist - Women's Health | AP30000331 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan Lee Shane is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Susan Lee Shane, ARNP
Po Box 153, 411 Calawah,
Forks, WA 98331-0153
Ph: (360) 374-9180 | Susan Lee Shane, ARNP
390 Founders Way, Suite 1,
Forks, WA 98331-9062
Ph: (360) 374-9180 |
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