| Doctor Name: | SUSAN LEE SHANE |
| NPI Number: | 1366456832 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | RN00050684 |
| Business Practice Address: | 390 Founders Way Suite 1 Forks, WA - 983319062 |
| Business Phone Number: | 3603749180 |
| Business Fax Number: | 3603743162 |
| Mailing Address: | Po Box 153, 411 Calawah FORKS |
| State: | WA |
| Postal Code: | 983310153 |
| Phone Number: | 3603749180 |
| Fax Number: | 3603743162 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 06/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WW0101X |
| License Number: | RN00050684 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Women's Health Care, Ambulatory |
| Taxonomy Definition: | |