Provider Demographics
NPI:1659462927
Name:POKLE-SOANS, SMITA (LMP)
Entity Type:Individual
Prefix:MS
First Name:SMITA
Middle Name:
Last Name:POKLE-SOANS
Suffix:
Gender:F
Credentials:LMP
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 2131
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0095
Mailing Address - Country:US
Mailing Address - Phone:425-392-4673
Mailing Address - Fax:425-391-1174
Practice Address - Street 1:3707 PROVIDENCE POINT DR SE STE D
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6216
Practice Address - Country:US
Practice Address - Phone:425-392-4673
Practice Address - Fax:425-391-1174
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist