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Dr. Daniel Susanto, MD
Neuroradiology Physician in Lynnwood, Washington
NPI 1144364605

Daniel Susanto is a Neuroradiology Physician based in Lynnwood, WA and is specialized in Neuroradiology. Daniel Susanto practices in Lynnwood, WA and has the professional credentials of MD. The NPI Number for Daniel Susanto is 1144364605 and holds a License No. 17687 (Washington).

The current practice location address for Daniel Susanto is 19020 33Rd Ave W Ste 210, Lynnwood, WA and can be reached out via phone at 425-563-1500 and via fax at 425-563-1501.

Location: 19020 33Rd Ave W Ste 210, Lynnwood, WA, 98036-4748
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Provider Profile Details
NPI Number
1144364605
Provider Name
Daniel Susanto
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
19020 33Rd Ave W Ste 210, Lynnwood, WA, 98036-4748
Phone Number
425-563-1500
Fax Number
425-563-1501
Provider Enumeration Date
02/17/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1144364605 05 ID
263299 01 WA LNI
1584895 05 AK
263302 01 WA LNI
263305 01 WA LNI
2007663 05 WA
institution
Provider Business Practice Location Address Details
Address
19020 33Rd Ave W Ste 210
City
State
Zip
98036-4748
Phone Number
425-563-1500
Fax Number
425-563-1501
person
Provider Business Mailing Address Details
Address
19020 33Rd Ave W Ste 210
City
State
Zip
98036-4748
Phone Number
425-563-1500
Fax Number
425-563-1501
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Neuroradiology
Taxonomy
License No.
MD60083485 (Washington)
Definition
A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
17687 (Minnesota)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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