Individual
IZABELLA SURENYANTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20200 54TH AVE W, LYNNWOOD, WA 98036-6318
(425) 672-6400
Mailing address
20200 54TH AVE W, LYNNWOOD, WA 98036-6318
(425) 672-6400
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA100004977
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0218219
LIWA
WA
01
—
605960012
FBL
WA
01
—
6494SU
BSWA
WA
05
—
8457723
—
WA
Enumeration date
06/11/2006
Last updated
05/04/2021
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