SUZETTE WIDDISON IVERSON MPH PAC NPI 1144204173

NPI Information

NPI: 1144204173
Provider Name: SUZETTE WIDDISON IVERSON, MPH PAC
Classification: Physician Assistant - 363A00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 4700 POINT FOSDICK DR STE 220
GIG HARBOR, WA
ZIP 98335
Phone: (253) 851-5121

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NPI Details

Suzette Widdison Iverson, MPH PAC is a physician assistant in Gig Harbor, WA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Suzette Widdison Iverson, MPH PAC NPI is 1144204173. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4700 POINT FOSDICK DR STE 220
GIG HARBOR, WA
ZIP 98335-706
Phone: (253) 851-5121
Fax: (253) 851-3059

The NPI 1144204173 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 12/2/2005 and was last updated on 5/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA10004945	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0239348	OTHER	WASHINGTON	STATE L&I
2	G8907654	OTHER	WASHINGTON	MEDICARE
3	8500191	MEDICAID	WASHINGTON
4	0291728	OTHER	WASHINGTON	L&I

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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