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NPI Code Detail

MEDICARE: JASON J SUH MD

MEDICARE: JASON J SUH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RX0202XMedical Oncology Physician25341NV
2207RX0202XMedical Oncology PhysicianMD00034987WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111451923OTHERNVCAQH
225341OTHERNVNV MD LICENSE

General Provider Information

NPI Number : 1225024722
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON J SUH MD
Provider Business Mailing Address
First Line : 1155 MILL ST # M14
Second Line :
City : RENO
State : NV
Zip : 89502-1576
Country : US
Telephone Number : 775-982-5262
Fax Number : 775-982-5775
Provider Business Practice Location Address
First Line : 834 SHERIDAN ST
Second Line :
City : PORT TOWNSEND
State : WA
Zip : 98368-2443
Country : US
Telephone Number : 360-344-3091
Fax Number : 360-344-3082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 06/23/2025

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