Individual
SUSAN R WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
910 BOYLSTON AVE, SEATTLE, WA 98104-1313
(206) 215-2440
(206) 215-2457
Mailing address
PO BOX 84026, SEATTLE, WA 98124-8426
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ID00000585
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8430050
—
WA
Enumeration date
12/21/2006
Last updated
02/18/2009
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