Provider Demographics
NPI:1043653256
Name:ZWEIFEL, SUZANNA (LMP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNA
Middle Name:
Last Name:ZWEIFEL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 MAIN ST.
Mailing Address - Street 2:STE. 102
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2260
Mailing Address - Country:US
Mailing Address - Phone:360-695-7699
Mailing Address - Fax:360-695-1503
Practice Address - Street 1:3600 MAIN ST.
Practice Address - Street 2:STE. 102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2260
Practice Address - Country:US
Practice Address - Phone:360-695-7699
Practice Address - Fax:360-695-1503
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60263414225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist