Suzan Lynn Dula, PSYD, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10002915 Issued in WA

Practice address

2204 Pacific Ave N
Long Beach, WA 98631-3300

Phone

(360) 642-3787

Fax

(360) 642-2096

NPI assigned

Sep 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neuroeducation Inc PC

  • Clinical Psychologist
  • Spokane, WA
  • NPI 1982694923
  NPD (past)

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1942583372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W RIVERSIDE AVE STE 208",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992011099",
            "telephone_number": "509-747-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787",
            "fax_number": "360-642-2096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Va Ctr",
            "address_2": "116A",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043306719",
            "country_code": "US",
            "telephone_number": "360-281-1233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 W Riverside Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992011099",
            "country_code": "US",
            "telephone_number": "509-747-0165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DULA",
        "first_name": "SUZAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSYD, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10002915",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60420557",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Danielson
• Janet Darcher
• Darren L Thorsen, OD
• Tara Dockery
• Joy N Douglas, LPN
• Carol Pauline Dunning, LICSW
• Ariel Eaton
• Kathy Edison
• Kathryn Eicher
• Allianna Elgin

• Medical Physician Assistant in Long Beach, WA
• Providers in Long Beach, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.