Individual
MRS. SUZANNE M RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
11216 SUNRISE BLVD E STE 3-102, PUYALLUP, WA 98374-8848
(253) 848-3000
(253) 845-8750
Mailing address
1703 S MERIDIAN STE 101, PUYALLUP, WA 98371-7590
(253) 848-3000
(253) 845-8750
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004546
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8372955
—
WA
Enumeration date
08/31/2006
Last updated
05/07/2018
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