Provider Demographics
NPI:1972752772
Name:FRIEDRICH, SUSAN ELAINE (ACUPUNCTURE/ORIENTAL)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELAINE
Last Name:FRIEDRICH
Suffix:
Gender:F
Credentials:ACUPUNCTURE/ORIENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 164TH STREET SE
Mailing Address - Street 2:#183
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:425-405-0578
Mailing Address - Fax:
Practice Address - Street 1:10303 19TH AVE SE
Practice Address - Street 2:#B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208
Practice Address - Country:US
Practice Address - Phone:425-405-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC600023290171100000X
FLAP2405171100000X
WA600023290171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1972752772OtherNPI