Individual
NEIHL OMAR SUWARNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A. - C
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-2319
(360) 756-6666
Mailing address
1100 OLIVE WAY, M4-PFS, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004525
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093771537
MONTANA DSHS
WA
05
—
8372674
—
WA
Enumeration date
04/25/2006
Last updated
01/11/2013
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