DARYL SUDASENA

OLYMPIA, WA
NPI1295153880
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RI0011X Internal Medicine, Interventional Cardiology
(Licence: WA  MD61145791)
Additional Taxonomies207R00000X Internal Medicine
(Licence: TX  R9445)
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: NY  307858)
Enumeration Date2014-04-01
Last Update Date2022-05-03
Business Address
DARYL SUDASENA
406 BLACK HILLS LN SW
OLYMPIA, WA 98502-8143
Phone number: 360-754-1735
Mailing Address
DARYL SUDASENA
406 BLACK HILLS LN SW
OLYMPIA, WA 98502-8143
Phone number: 360-754-1735