Provider Demographics
NPI:1437343241
Name:LIN, SUSANNA LUCINDA (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:SUSANNA
Middle Name:LUCINDA
Last Name:LIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SUSANNA
Other - Middle Name:LUCINDA
Other - Last Name:PAPPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:2409 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6907
Practice Address - Country:US
Practice Address - Phone:206-633-8100
Practice Address - Fax:206-632-1420
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10860225100000X
WAPT 00010860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist