Provider Demographics
NPI:1225159908
Name:SUVER, JEFFREY M (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:SUVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 QUEEN ANNE AVE N STE 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4553
Mailing Address - Country:US
Mailing Address - Phone:206-352-8191
Mailing Address - Fax:206-352-8190
Practice Address - Street 1:323 QUEEN ANNE AVE N STE 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4553
Practice Address - Country:US
Practice Address - Phone:206-352-8191
Practice Address - Fax:206-352-8190
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB23746Medicare ID - Type Unspecified