Individual
LYNN SUSANNE SUDDUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19245 7TH AVE NE, POULSBO, WA 98370-7504
(360) 782-3500
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00024682
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070012924
RAILROAD MEDICARE
—
01
—
100670
LABOR & INDUSTRIES
WA
05
—
1089853
—
WA
01
—
1918SU
REGENCE BLUESHIELD
—
01
—
4648199
AETNA
—
Enumeration date
06/17/2006
Last updated
03/07/2023
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