Healthcare Provider Details

I. General information

NPI: 1972893089
Provider Name (Legal Business Name): MRS. SUZANNE COKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2011
Last Update Date: 04/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 DENSMORE AVE N
SEATTLE WA
98103-6754
US

IV. Provider business mailing address

4901 DENSMORE AVE N
SEATTLE WA
98103-6754
US

V. Phone/Fax

Practice location:
  • Phone: 206-818-8238
  • Fax:
Mailing address:
  • Phone: 206-818-8238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number603057395
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: