Basic Information
Provider Information
NPI: 1528196490
EntityType: 2
ReplacementNPI:  
OrganizationName: SUZANNE J ADAMS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 14136 NE WOODINVILLE DUVALL RD
Address2: NUMBER 214
City: WOODINVILLE
State: WA
PostalCode: 980728551
CountryCode: US
TelephoneNumber: 2064392988
FaxNumber: 2064313939
Practice Location
Address1: 4744 41ST AVE SW
Address2: SUITE 106
City: SEATTLE
State: WA
PostalCode: 981164570
CountryCode: US
TelephoneNumber: 2069375356
FaxNumber: 2069375366
Other Information
ProviderEnumerationDate: 03/01/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ADAMS
AuthorizedOfficialFirstName: SUZANNE
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: OWNER ARNP
AuthorizedOfficialTelephone: 2069375356
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X WAY193400000X SINGLE SPECIALTY GROUPNursing Service ProvidersRegistered Nurse 

No ID Information.


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