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General NPI Number Information
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NPI Number | 1700220811
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Entity Type | Individual
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Provider Name | JULIEN SUCCAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1615 DELAWARE ST
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City | LONGVIEW
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State | WA
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Zip | 98632-2367
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Country | US
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Telephone | 360-501-3601
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Fax | 360-501-3648
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Provider Business Mailing Address
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Address Line | 1115 SE 164TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98683-9324
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Country | US
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Telephone | 360-729-1253
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Fax | 360-729-3185
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | MD61538691
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | MD185419
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD61538691
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License Number State | WA
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