Provider Demographics
NPI:1770575110
Name:SURIANO, CYNTHIA M (DC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:M
Last Name:SURIANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 W LINCOLN AVE
Mailing Address - Street 2:STE A
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2414
Mailing Address - Country:US
Mailing Address - Phone:509-972-1339
Mailing Address - Fax:509-834-2097
Practice Address - Street 1:2117 W LINCOLN AVE
Practice Address - Street 2:STE A
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2414
Practice Address - Country:US
Practice Address - Phone:509-972-1339
Practice Address - Fax:509-834-2097
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH3357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5060SUOtherREGENCE BLUE SHIELD
WA124105OtherL&I
WAU72912Medicare UPIN
WA124105OtherL&I