Individual
GREGORY SUSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED DIETITIAN
Contact information
Practice address
1040 STEVENSON AVE, STE A, ENUMCLAW, WA 98022-2991
(360) 825-7411
(360) 825-7434
Mailing address
24060 SE KENT- KANGLEY RD ST D100, MAPLE VALLEY, WA 98038
(425) 433-0123
(425) 433-0733
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60471513
WA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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