Individual
DEREK E SUCHARDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
380 CHASE ST, WALLA WALLA, WA 99362
(509) 522-5820
(509) 522-5570
Mailing address
PO BOX 2292, WALLA WALLA, WA 99362
(509) 522-5815
(509) 522-5818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1081678
—
WA
Enumeration date
08/17/2006
Last updated
07/08/2007
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