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NPI Code Detail

MEDICARE: CHRISTINE SUYDAM

MEDICARE: CHRISTINE SUYDAM
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
12084P0800XPsychiatry PhysicianMD00034974WA

General Provider Information

NPI Number : 1518976828
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE SUYDAM
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number : 206-401-3175
Fax Number : 206-401-3201
Provider Business Practice Location Address
First Line : 1201 N 175TH ST
Second Line :
City : SHORELINE
State : WA
Zip : 98133-5064
Country : US
Telephone Number : 206-401-3175
Fax Number : 206-401-3201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 09/08/2020

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Directions to “ CHRISTINE SUYDAM ” Practice Location

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