Provider Demographics
NPI:1649711201
Name:SUTER, PAMELA JEAN (RN)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEAN
Last Name:SUTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15320 MILL CREEK BLVD
Mailing Address - Street 2:V103
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1736
Mailing Address - Country:US
Mailing Address - Phone:425-231-3440
Mailing Address - Fax:
Practice Address - Street 1:15320 MILL CREEK BLVD
Practice Address - Street 2:V103
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1736
Practice Address - Country:US
Practice Address - Phone:425-231-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN657100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse