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Daniel Susanto

  • Male

Medical Specialty

Professional ID

  • NPI: 1144364605
  • PECOS ID: 6507999299
  • Enrollment ID: I20100802000582
  • Credential(MD, DO, DPM):
  • Medical School: Medical College Of Wisconsin
  • Medical School Graduation Year: 2004

Hospital Service

  • Hospital CCN1: 500025
  • Business Name (LBN)1: Swedish Medical Center Cherry Hill
  • Hospital CCN2: 500124
  • Business Name (LBN)2: Evergreenhealth Medical Center
  • Hospital CCN3: 500051
  • Business Name (LBN)3: Overlake Hospital Medical Center
  • Hospital CCN4: 500152
  • Business Name (LBN)4: Swedish Issaquah
  • Hospital CCN5: 500027
  • Business Name (LBN)5: Swedish Medical Center

Medical Practices

  • Organization Name: Columbia Basin Imaging Pc
  • Group Practice ID assigned by PECOS: 0345145264
  • Number of Group Practice member: 65

Location

  • Address1: 12606 E Mission Ave
  • Address2:
  • City: Spokane
  • State: Washington
  • Zip Code: 99216
  • Phone Number: (509)924-6650

Location

  • Address1: 14701 179th Ave Se
  • Address2:
  • City: Monroe
  • State: Washington
  • Zip Code: 98272
  • Phone Number: (360)794-1409

Location

  • Address1: 1600 E Jefferson St
  • Address2:
  • City: Seattle
  • State: Washington
  • Zip Code: 98122
  • Phone Number: (206)320-3700

Location

  • Address1: 500 17th Ave
  • Address2:
  • City: Seattle
  • State: Washington
  • Zip Code: 98122
  • Phone Number:

Location

  • Address1: 7320 216th St Sw
  • Address2:
  • City: Edmonds
  • State: Washington
  • Zip Code: 98026
  • Phone Number: (425)673-3930

Location

  • Address1: 888 Swift Blvd
  • Address2:
  • City: Richland
  • State: Washington
  • Zip Code: 99352
  • Phone Number: (509)943-5616

Medical Practices

  • Organization Name: Evergreen Radia Llc
  • Group Practice ID assigned by PECOS: 4587568076
  • Number of Group Practice member: 92

Location

  • Address1: 11521 Ne 128th St
  • Address2: Suite 200
  • City: Kirkland
  • State: Washington
  • Zip Code: 98034
  • Phone Number: (425)952-6100

Medical Practices

  • Organization Name: Swedish Radia Imaging Center At Edmonds Llc
  • Group Practice ID assigned by PECOS: 5496778292
  • Number of Group Practice member: 85

Location

  • Address1: 21700 Hwy 99
  • Address2:
  • City: Edmonds
  • State: Washington
  • Zip Code: 98026
  • Phone Number: (425)297-6200

Medical Practices

  • Organization Name: Wenatchee Valley Hospital
  • Group Practice ID assigned by PECOS: 9537309869
  • Number of Group Practice member: 575

Location

  • Address1: 820 N Chelan Ave
  • Address2:
  • City: Wenatchee
  • State: Washington
  • Zip Code: 98801
  • Phone Number: (509)663-8711

Medical Practices

  • Organization Name: Radia Inc Ps
  • Group Practice ID assigned by PECOS: 9931012812
  • Number of Group Practice member: 170

Location

  • Address1: 12040 Ne 128th St
  • Address2:
  • City: Kirkland
  • State: Washington
  • Zip Code: 98034
  • Phone Number: (425)899-1800

Location

  • Address1: 1321 Colby Ave
  • Address2:
  • City: Everett
  • State: Washington
  • Zip Code: 98201
  • Phone Number: (425)261-4100

Location

  • Address1: 1600 E Jefferson St
  • Address2: Suite 203
  • City: Seattle
  • State: Washington
  • Zip Code: 98122
  • Phone Number: (425)297-6200

Location

  • Address1: 21601 76th Ave W
  • Address2:
  • City: Edmonds
  • State: Washington
  • Zip Code: 98026
  • Phone Number: (425)640-4250

Location

  • Address1: 500 17th Ave
  • Address2:
  • City: Seattle
  • State: Washington
  • Zip Code: 98122
  • Phone Number: (206)320-3700

Location

  • Address1: 747 Broadway
  • Address2:
  • City: Seattle
  • State: Washington
  • Zip Code: 98122
  • Phone Number: (206)386-6000

Location

  • Address1: 747 Broadway Rm
  • Address2: Suite 404
  • City: Seattle
  • State: Washington
  • Zip Code: 98122
  • Phone Number: (206)386-6000

Location

  • Address1: 751 Ne Blakely Dr
  • Address2: Suite 3020
  • City: Issaquah
  • State: Washington
  • Zip Code: 98029
  • Phone Number: (425)313-7000

Location

  • Address1: 939 Caroline St
  • Address2:
  • City: Port Angeles
  • State: Washington
  • Zip Code: 98362
  • Phone Number: (360)417-7441

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
  • Used Electronic health record (EHR):