Provider Demographics
NPI:1619380052
Name:SINGH, SONALI (MD)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S 320TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4691
Mailing Address - Country:US
Mailing Address - Phone:253-838-1520
Mailing Address - Fax:360-744-5123
Practice Address - Street 1:700 S 320TH ST STE B
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4691
Practice Address - Country:US
Practice Address - Phone:253-838-1520
Practice Address - Fax:360-744-5123
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60859309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2108130Medicaid