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General NPI Number Information
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NPI Number | 1780047613
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Entity Type | Individual
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Provider Name | SUSIE SABUNCIYAN EAMP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 4556 UNIVERSITY WAY NE SUITE 222
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City | SEATTLE
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State | WA
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Zip | 98105-4581
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Country | US
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Telephone | 206-280-8341
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Fax |
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Provider Business Mailing Address
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Address Line | 614 21ST AVE
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City | SEATTLE
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State | WA
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Zip | 98122-5910
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Country | US
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Telephone | 206-280-8341
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC60050322
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License Number State | WA
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