Susan Gaye Pagon, L.M.P.
Mechanotherapist in Vancouver, WA. Individual provider (NPI-1).
NPI number1215252002
StatusActive
Last updated in NPPESApr 5, 2010
Details
- NPI
- 1215252002
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Susan Gaye Pagon
- Credential
- L.M.P.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 5, 2010
- Last updated
- Apr 5, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172M00000X | Mechanotherapist | MA00022788 | WA | Yes |
Practice location
104 Se 107th AveVancouver, WA 98664-4653
Phone 360-904-9076
Mailing address
104 Se 107th AveVancouver, WA 98664-4653
Phone 360-904-9076
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