Active NPI
Robert E Suchert DO PS
- Family Medicine Physician
- Edmonds, WA
National Provider Identifier
1205014388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP00000563
- Legal business name
- ROBERT E SUCHERT DO PS
- Practice address
- 617 5TH Ave S
Edmonds, WA 98020 - Phone
- (425) 774-5113
- Fax
- (425) 774-5114
- NPI assigned
- Jan 31, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert E Suchert, DO PS
- Title
- President Owner
- Phone
- (425) 774-5113
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OP00000563 | WA | Primary |
Addresses
Primary practice location
617 5TH Ave S
Edmonds, WA 98020
Mailing address
PO Box 2003
Edmonds, WA 98020
Phone (425) 774-5113
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040601 | Other | WA | L AND I |
| 1856202 | Medicaid | WA |
National Provider Directory
National Provider DirectoryLocations
617 5th Ave S
Edmonds, WA 98020
Phone (206) 629-5180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1201737600000",
"number": "1205014388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2003",
"city": "EDMONDS",
"state": "WA",
"postal_code": "98020",
"telephone_number": "425-774-5113",
"fax_number": "425-774-5114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 5TH AVE S",
"city": "EDMONDS",
"state": "WA",
"postal_code": "98020",
"telephone_number": "425-774-5113",
"fax_number": "425-774-5114"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROBERT E SUCHERT DO PS",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-31",
"last_updated": "2008-01-31",
"status": "A",
"authorized_official_last_name": "SUCHERT",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT OWNER",
"authorized_official_telephone_number": "425-774-5113",
"authorized_official_credential": "DO PS"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "WA",
"license": "OP00000563",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L AND I",
"identifier": "040601",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1856202",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.