Provider Demographics
NPI:1952802738
Name:VARNEY, SUZANNAH
Entity Type:Individual
Prefix:
First Name:SUZANNAH
Middle Name:
Last Name:VARNEY
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 1:19713 68TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-5614
Mailing Address - Country:US
Mailing Address - Phone:253-590-6391
Mailing Address - Fax:253-590-6391
Practice Address - Street 1:400 29TH ST NE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6774
Practice Address - Country:US
Practice Address - Phone:253-840-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60809574224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant