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Individual

SUREE CHOMMUANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
840 N 5TH AVE, SEQUIM, WA 98382-3045
(360) 582-2930
Mailing address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30006362
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1709IT
REGENCE BLUE SHIELD RIDER
05
9647306
WA
Enumeration date
03/17/2006
Last updated
09/24/2014
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