Provider Demographics
NPI:1720208051
Name:FLANDERS, SUZAN TRAM (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUZAN
Middle Name:TRAM
Last Name:FLANDERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12927 NE 101ST PL
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5276
Mailing Address - Country:US
Mailing Address - Phone:425-306-1196
Mailing Address - Fax:
Practice Address - Street 1:910 LENORA STREET
Practice Address - Street 2:#152
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121
Practice Address - Country:US
Practice Address - Phone:206-405-3565
Practice Address - Fax:206-652-9727
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH45799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist