Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DE60122941 | WA |
NPI | 1013039429 |
---|---|
Provider Name | Dr. Pamela Nancy Sursely |
First Address | Kirkland, WA 98034-3027 |
Second Address | Kirkland, WA 98034-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2007 |
Last Update Date | 06/05/2010 |