Individual
MRS. SUSAN GAYE PAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
104 SE 107TH AVE, VANCOUVER, WA 98664-4653
(360) 904-9076
Mailing address
104 SE 107TH AVE, VANCOUVER, WA 98664-4653
(360) 904-9076
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00022788
WA
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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