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General NPI Number Information
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NPI Number | 1598144701
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Entity Type | Organization
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Legal Business Name | SUZZANNE MYER CONSULTING LLC
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 11520 NE 20TH ST SUITE B
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City | BELLEVUE
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State | WA
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Zip | 98004-3005
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Country | US
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Telephone | 206-371-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 11520 NE 20TH ST SUITE B
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City | BELLEVUE
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State | WA
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Zip | 98004-3005
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Country | US
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Telephone | 206-371-7111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUZZANNE NELSON MYER
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Credential | R.D.
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Telephone | 206-371-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DI00001076
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License Number State | WA
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