Individual
JASON J SUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 501-3601
(360) 501-3648
Mailing address
PO BOX 249, LONGVIEW, WA 98632-7154
(360) 414-2048
(360) 575-6749
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00034987
WA
208M00000X
Hospitalist Physician
MD00034987
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110197712
RR MEDICARE
—
01
—
126462
LABOR & IND.
WA
05
—
150259
—
OR
05
—
8209124
—
WA
01
—
8923177
CRIME VICTIMS
WA
Enumeration date
08/09/2005
Last updated
05/16/2011
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