Jackie Sutherland

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

RC60013943 Issued in WA

Practice address

10407 Airport Rd
Everett, WA 98204-3540

Phone

(425) 737-9100

NPI assigned

Apr 11, 2008

Last updated

Apr 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1609049451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10407 AIRPORT RD",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10407 AIRPORT RD",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043540",
            "telephone_number": "425-737-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "JACKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "RC60013943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boonlert Sureepisarn, MHP
• Beverly Surface
• Pratap Suryadevara, PHARMACIST
• Harlyn Kaur Susarla, DMD, MPH
• Peter D Sutcliffe, MD
• Alyce Sutko, M.D./M.P.H.
• Tristin Sue Sutliffe, HS, CPC
• Sheila Suttoncarter
• Manaji M Suzuki, MD
• Jessica Ann Sved, PT

• Community Health Worker in Everett, WA
• Providers in Everett, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.

Verify at the official NPI Registry.