MEDICARE: SUE C ENG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD00037348	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0158432	OTHER	WA	LABOR AND INDUSTRIES
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184603425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUE C ENG MD

Provider Business Mailing Address
First Line	:	PO BOX 34888
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1888
Country	:	US
Telephone Number	:	425-977-4620
Fax Number	:	425-745-9836

Provider Business Practice Location Address
First Line	:	11800 NE 128TH ST
Second Line	:	SUITE 100
City	:	KIRKLAND
State	:	WA
Zip	:	98034-7208
Country	:	US
Telephone Number	:	425-899-4500
Fax Number	:	425-899-4510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	03/19/2014

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Directions to “ SUE C ENG MD” Practice Location

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