Provider Demographics
NPI:1568621464
Name:SIMS, SUZANNE LENORA (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LENORA
Last Name:SIMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 29TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-7532
Mailing Address - Country:US
Mailing Address - Phone:253-939-0090
Mailing Address - Fax:253-939-0095
Practice Address - Street 1:502 29TH ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-7532
Practice Address - Country:US
Practice Address - Phone:253-939-0090
Practice Address - Fax:253-939-0095
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist