Provider Demographics
NPI:1326184904
Name:SOULIA, ALEJANDRO S (MED)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:S
Last Name:SOULIA
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:ALEJANDRO
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1175 CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3300
Mailing Address - Country:US
Mailing Address - Phone:509-943-9104
Mailing Address - Fax:509-943-7206
Practice Address - Street 1:1175 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3300
Practice Address - Country:US
Practice Address - Phone:509-943-9104
Practice Address - Fax:509-943-7206
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60156019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health