Healthcare Provider Details

I. General information

NPI: 1104905561
Provider Name (Legal Business Name): SUZANNE M, RAMM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N. 39TH AVE. STE#200
YAKIMA WA
98902
US

IV. Provider business mailing address

602 N. 39TH AVE. SUITE 200
YAKIMA WA
98902
US

V. Phone/Fax

Practice location:
  • Phone: 509-452-0279
  • Fax: 509-457-6306
Mailing address:
  • Phone: 509-452-0279
  • Fax: 509-457-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN00114538
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAP30007121
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: