Provider Demographics
NPI:1073790861
Name:ELEANOR SUTHERLAND M.D.
Entity Type:Organization
Organization Name:ELEANOR SUTHERLAND M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OSTRANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-759-3065
Mailing Address - Street 1:5100 SW 316TH PLACE
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2037
Mailing Address - Country:US
Mailing Address - Phone:253-759-3065
Mailing Address - Fax:253-759-3075
Practice Address - Street 1:5100 SW 316TH PLACE
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2037
Practice Address - Country:US
Practice Address - Phone:253-759-3065
Practice Address - Fax:253-759-3075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty