Individual
MS. JORDAN SUCHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
435 MURRAY CIRCLE, SAUSALITO, CA 94965
(415) 331-8247
Mailing address
435 MURRAY CIRCLE, SAUSALITO, CA 94965
(415) 331-8247
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1394556935
DODID
—
Enumeration date
12/08/2021
Last updated
12/08/2021
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