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General NPI Number Information
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NPI Number | 1972061174
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Entity Type | Individual
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Provider Name | SUZANNA AVERY ARNP, CNM
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Gender | Female
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 12303 NE 130TH LN STE CORAL225
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City | KIRKLAND
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State | WA
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Zip | 98034-3099
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Country | US
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Telephone | 425-899-4012
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Fax |
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Provider Business Mailing Address
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Address Line | 12040 NE 128TH ST
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City | KIRKLAND
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State | WA
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Zip | 98034-3013
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Country | US
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Telephone | 808-393-1370
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | AP61081030
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN60449303
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License Number State | WA
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