Provider Demographics
NPI:1861376253
Name:WARURU, SUSAN W
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:W
Last Name:WARURU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 WAYMIRE ST NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-1803
Mailing Address - Country:US
Mailing Address - Phone:972-801-8814
Mailing Address - Fax:503-390-1041
Practice Address - Street 1:1923 WAYMIRE ST NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-1803
Practice Address - Country:US
Practice Address - Phone:972-801-8814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202104338RN163WC1500X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management