Bouterse, Susan E

Bouterse, Susan E is an individual health care provider with primary practice located at 4700 Point Fosdick Dr Nw Ste 319 , Gig Harbor WA 98335-1706. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bouterse, Susan E can be contacted via phone (253) 853-3888.

Contact Information

Primary practice address
4700 Point Fosdick Dr Nw Ste 319 Gig Harbor WA 98335-1706
Phone: (253) 853-3888
Fax: (253) 853-7393
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00035719 Washington

Profile Details

NPI number 1710903547
LBN Legal business name Bouterse, Susan E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Dec 21st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710903547 NPPES
Washington MEDICAID 8231326

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