Provider Demographics
NPI:1902954621
Name:SARMASTI, SUZANNE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:SARMASTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 WOODS CT
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9542
Mailing Address - Country:US
Mailing Address - Phone:541-400-0266
Mailing Address - Fax:800-796-7703
Practice Address - Street 1:1631 WOODS CT
Practice Address - Street 2:SUITE 101
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9542
Practice Address - Country:US
Practice Address - Phone:541-400-0266
Practice Address - Fax:800-796-7703
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71-3701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor