| Doctor Name: | GREGORY SUSINGER |
| NPI Number: | 1952700551 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | REGISTERED DIETITIAN |
| License Number: | DI60471513 |
| Business Practice Address: | 1040 Stevenson Ave Ste A Enumclaw, WA - 980222991 |
| Business Phone Number: | 3608257411 |
| Business Fax Number: | 3608257434 |
| Mailing Address: | 24060 Se Kent- Kangley Rd St D100, MAPLE VALLEY |
| State: | WA |
| Postal Code: | 98038 |
| Phone Number: | 4254330123 |
| Fax Number: | 4254330733 |
| NPI Enumeration Date: | 08/19/2014 |
| NPI Last Update Date: | 08/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DI60471513 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |