Provider Demographics
NPI:1982832028
Name:SUHRE, WENDY MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MICHELLE
Last Name:SUHRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:MICHELLE
Other - Last Name:BARENDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-28
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60454315207L00000X
SC31981207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1982832028Medicaid