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Organization

SUSEELA NARRA DERMATOLOGY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY SMITH (OFFICE MANAGER)
(425) 677-8876
Entity
Organization

Contact information

Practice address
710 NW JUNIPER ST, SUITE #204, ISSAQUAH, WA 98027-2717
(425) 677-8867
Mailing address
710 NW JUNIPER ST, SUITE #204, ISSAQUAH, WA 98027-2717
(425) 677-8867

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD0040430
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0211NA
REGENCE
WA
Enumeration date
09/30/2011
Last updated
05/11/2012
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