Provider Demographics
NPI:1043910995
Name:SOTO, NOEMI RUT
Entity Type:Individual
Prefix:
First Name:NOEMI
Middle Name:RUT
Last Name:SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:
Other - Last Name:CORRAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2103 N 5TH AVE TRLR 69
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3683
Mailing Address - Country:US
Mailing Address - Phone:509-410-5414
Mailing Address - Fax:
Practice Address - Street 1:2103 N 5TH AVE TRLR 69
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-3683
Practice Address - Country:US
Practice Address - Phone:509-410-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter