Provider Demographics
NPI:1376789222
Name:SORIA, AMBER LOUISE (LMT,LA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LOUISE
Last Name:SORIA
Suffix:
Gender:F
Credentials:LMT,LA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30013
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98113-2013
Mailing Address - Country:US
Mailing Address - Phone:425-444-0302
Mailing Address - Fax:425-977-0303
Practice Address - Street 1:2110 116TH AVE NE STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3040
Practice Address - Country:US
Practice Address - Phone:425-260-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018585225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist