Healthcare Provider Details

I. General information

NPI: 1396875134
Provider Name (Legal Business Name): SUZANNE LYNN SYKURSKI NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E SUNSET WAY STE B
ISSAQUAH WA
98027-3473
US

IV. Provider business mailing address

PO BOX 1975
ISSAQUAH WA
98027-0084
US

V. Phone/Fax

Practice location:
  • Phone: 425-890-2072
  • Fax: 425-642-3220
Mailing address:
  • Phone: 425-890-2072
  • Fax: 425-642-3220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001351
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: