Individual
SUSAN I BOHNEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7316
(509) 241-7349
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003239
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8363335
—
WA
Enumeration date
03/21/2007
Last updated
05/09/2008
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