Provider Demographics
NPI:1831303841
Name:ALONGI, SUSANNA ROBIN (LMP)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:ROBIN
Last Name:ALONGI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 DUPONT ST # 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4021
Mailing Address - Country:US
Mailing Address - Phone:360-510-4133
Mailing Address - Fax:
Practice Address - Street 1:700 DUPONT ST # 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4021
Practice Address - Country:US
Practice Address - Phone:360-510-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
WAMA00012685225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula