Provider Demographics
NPI:1134769110
Name:JONES, SUZANNE SHAWNA ZIMMERMAN
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:SHAWNA ZIMMERMAN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10602 62ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2418
Mailing Address - Country:US
Mailing Address - Phone:253-905-8888
Mailing Address - Fax:
Practice Address - Street 1:2310 130TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1757
Practice Address - Country:US
Practice Address - Phone:425-882-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst