Individual
KEVIN N SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1959 NE PACIFIC STREET, BB-1469, SEATTLE, WA 98195-6540
(206) 543-2673
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD61263725
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962908129
—
WA
Enumeration date
04/04/2018
Last updated
08/15/2022
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