Provider Demographics
NPI:1962493684
Name:SUTHERLAND, VALERIE HOPE SLOCUM (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:HOPE SLOCUM
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21150
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-4150
Mailing Address - Country:US
Mailing Address - Phone:303-546-9158
Mailing Address - Fax:303-546-9107
Practice Address - Street 1:5713 WOLLOCHET DR NW STE 101
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-7371
Practice Address - Country:US
Practice Address - Phone:253-319-3339
Practice Address - Fax:706-416-4727
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000489992083B0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1093748Medicaid