Individual
ALLEN M SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
723 SW 10TH ST, STE 250, RENTON, WA 98055
(425) 656-4040
(425) 656-4046
Mailing address
PO BOX 59028, RENTON, WA 98058-2028
(425) 251-5110
(425) 793-4707
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00015978
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016607
L&I
WA
01
—
110202799
RR MEDICARE
WA
05
—
1487800
—
WA
Enumeration date
07/28/2006
Last updated
12/10/2009
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