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General NPI Number Information
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NPI Number | 1427041805
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Entity Type | Individual
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Provider Name | SUZANNE BAILY RD, CD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 6852 S 220TH ST
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City | KENT
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State | WA
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Zip | 98032-1963
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Country | US
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Telephone | 253-872-3460
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Fax | 253-872-3448
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Provider Business Mailing Address
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Address Line | 8552 18TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98117-3644
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Country | US
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Telephone | 206-962-1010
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Fax | 253-872-3448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DI00001873
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License Number State | WA
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