Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 39735 | WA |
NPI | 1558467712 |
---|---|
Provider Name | Cynthia Su |
First Address | Everett, WA 98206-5127 |
Second Address | Everett, WA 98201-4833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 15/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H97680 | (02) |