Provider Demographics
NPI:1740330257
Name:LINDBERG, SUZANNE C (ARNP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:C
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS: M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000067363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0039592OtherLABOR AND INDUSTRIES #
WAUS0818502OtherAETNA PCP PIN
WALI0005OtherBLUE SHIELD #
WAP00088979OtherRAILROAD MC#
WA9605528Medicaid
WA0039592OtherLABOR AND INDUSTRIES #
WALI0005OtherBLUE SHIELD #
WAG8886361Medicare PIN
WA8853130Medicare PIN
WAAB10253Medicare PIN