Provider Demographics
NPI:1306994868
Name:SUZANNE SARMASTI DC PC
Entity type:Organization
Organization Name:SUZANNE SARMASTI DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SARMASTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-400-0266
Mailing Address - Street 1:212 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-2082
Mailing Address - Country:US
Mailing Address - Phone:541-400-0266
Mailing Address - Fax:800-796-7703
Practice Address - Street 1:212 4TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2082
Practice Address - Country:US
Practice Address - Phone:541-400-0266
Practice Address - Fax:800-796-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71-3701261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center