Provider Demographics
NPI:1912045824
Name:FIRTH, SUZY J (LMP)
Entity Type:Individual
Prefix:
First Name:SUZY
Middle Name:J
Last Name:FIRTH
Suffix:
Gender:F
Credentials:LMP
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Mailing Address - Street 1:8905 GRAVELLY LAKE BLVD SW
Mailing Address - Street 2:CHITTENDEN CHIROPRACTIC
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2010
Mailing Address - Country:US
Mailing Address - Phone:253-581-1533
Mailing Address - Fax:253-588-2145
Practice Address - Street 1:8905 GRAVELLY LAKE DR SW
Practice Address - Street 2:CHITTENDEN CHIROPRACTIC
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3109
Practice Address - Country:US
Practice Address - Phone:253-581-1533
Practice Address - Fax:253-588-2145
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2012-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA91-1550534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA91-1550534OtherSTEPHEN CHITTENDEN