Provider Demographics
NPI:1134371552
Name:RUCHTI, SUZANNE JEAN BEECHER
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:JEAN BEECHER
Last Name:RUCHTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 57467
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-2467
Mailing Address - Country:US
Mailing Address - Phone:907-978-2167
Mailing Address - Fax:907-385-3911
Practice Address - Street 1:1805 ALDER ST
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-5422
Practice Address - Country:US
Practice Address - Phone:907-978-2167
Practice Address - Fax:907-385-3911
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator