Individual
MRS. SUSAN BANCROFT MACHUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1220 116TH AVE NE STE 203, BELLEVUE, WA 98004-3826
(206) 436-9883
Mailing address
10935 SE 23RD ST, BELLEVUE, WA 98004-7306
(206) 436-9883
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60081937
WA
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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