Provider Demographics
NPI:1598144701
Name:SUZZANNE MYER CONSULTING LLC
Entity Type:Organization
Organization Name:SUZZANNE MYER CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZZANNE
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:MYER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:206-371-7111
Mailing Address - Street 1:11520 NE 20TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3005
Mailing Address - Country:US
Mailing Address - Phone:206-371-7111
Mailing Address - Fax:
Practice Address - Street 1:11520 NE 20TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3005
Practice Address - Country:US
Practice Address - Phone:206-371-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001076261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center