Provider Demographics
NPI:1003904657
Name:ZWILLING, SONIA EDITH (MD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:EDITH
Last Name:ZWILLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:EDITH
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3292
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:8980 161ST AVE NE
Practice Address - Street 2:SUITE 400
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7554
Practice Address - Country:US
Practice Address - Phone:425-899-2273
Practice Address - Fax:425-899-2272
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA167384OtherWORKERS COMPENSATION
WAA007OtherTRICARE
WA8369936Medicaid
WAG8890254Medicare PIN
WAAB36454Medicare ID - Type UnspecifiedPART B MEDICARE
WA8369936Medicaid
WAG8900687Medicare PIN
WAG8897728Medicare PIN
WAH81438Medicare UPIN