Basic Information
| Provider Information | |||||||||
| NPI: | 1508912643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARP | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | BERYL | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | A.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 402 N 4TH STREET | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092483782 | ||||||||
| FaxNumber: | 5095456275 | ||||||||
| Practice Location | |||||||||
| Address1: | 1608 N ROAD 44 | ||||||||
| Address2: | |||||||||
| City: | PASCO | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993012667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5095439280 | ||||||||
| FaxNumber: | 5095456275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 11/28/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP 60125623 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | AP 60125623 | 01 | WA | STATE OF WASHINGTON BOARD OF NURSING | OTHER |