Provider Demographics
NPI:1578739967
Name:DILLON, SUE C (DO)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:C
Last Name:DILLON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4700 POINT FOSDICK DR NW
Mailing Address - Street 2:STE 102
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-853-2050
Mailing Address - Fax:253-853-2711
Practice Address - Street 1:4700 POINT FOSDICK DR NW
Practice Address - Street 2:STE 102
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-853-2050
Practice Address - Fax:253-853-2711
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35427207Q00000X
WAOP60231136207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0283140OtherL & I
WA0302371OtherSTATE L&I
WAG8902509OtherMEDICARE
WA0283143OtherL & I
WA0283143OtherL & I
WAG8902509OtherMEDICARE