Provider Demographics
NPI:1568141612
Name:TUMP, SUZANNE EILEEN (SUDPT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:EILEEN
Last Name:TUMP
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20916 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEBAY
Mailing Address - State:WA
Mailing Address - Zip Code:98349-9414
Mailing Address - Country:US
Mailing Address - Phone:262-515-5081
Mailing Address - Fax:
Practice Address - Street 1:400 WARREN AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98337-1487
Practice Address - Country:US
Practice Address - Phone:360-478-2366
Practice Address - Fax:360-373-2096
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61368752101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)