Provider Demographics
NPI:1639250251
Name:EDMISON, SUE ZEE (ND LM)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:ZEE
Last Name:EDMISON
Suffix:
Gender:F
Credentials:ND LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 77038
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177
Mailing Address - Country:US
Mailing Address - Phone:206-957-2015
Mailing Address - Fax:206-957-2016
Practice Address - Street 1:12317 15TH NE
Practice Address - Street 2:S 103
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-957-2015
Practice Address - Fax:206-957-2016
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000467175F00000X
WAMW00000105176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
5324EDOtherREGENCE INSURANCE FOR ND
ED0111OtherREGENCE INSURANCE FOR LM
WA7045677Medicaid