Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1134438831 |
---|---|
Provider Name | Martha Ann Suronen |
First Address | Vancouver, WA 98682-3597 |
Second Address | Vancouver, WA 98682-3597 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2010 |
Last Update Date | 06/10/2011 |