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Suzinne Pak Gorstein

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NPI Number Detailed Information

Provider Information:

Name: Suzinne Pak Gorstein
Gender: F
Provider License Number If Given: MD00045046

NPI Information:

NPI: 1215922638
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 12/11/2007

Provider Business Mailing Address:

Address: 6016 1ST AVE NW
Seattle, WA 98107
Phone Number: 2066792460
Fax Number:

Provider Business Practice Location Address:

Address: 325 9TH AVE BOX 359774
Seattle, WA 98104
Phone Number: 2067449512
Fax Number: 2067449862

Provider Taxonomy:

Primary: 2080A0000X
Secondary (if any):
State: WA

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