Provider Demographics
NPI:1578789863
Name:MUELLER, SUSAN HODGE (ND)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:HODGE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7247 NE 171ST LN
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-6215
Mailing Address - Country:US
Mailing Address - Phone:425-780-9086
Mailing Address - Fax:
Practice Address - Street 1:7247 NE 171ST LN
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-6215
Practice Address - Country:US
Practice Address - Phone:425-780-9086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005596225700000X
WANT60185263175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist