Provider Demographics
NPI:1508484395
Name:SOULEK, ALIA EMILIE
Entity Type:Individual
Prefix:
First Name:ALIA
Middle Name:EMILIE
Last Name:SOULEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALIA
Other - Middle Name:EMILIE
Other - Last Name:ALSHARE-SOULEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16414 S DOVER RD
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-9602
Mailing Address - Country:US
Mailing Address - Phone:509-822-0211
Mailing Address - Fax:
Practice Address - Street 1:122 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2349
Practice Address - Country:US
Practice Address - Phone:509-474-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61084974363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner