Provider Demographics
NPI:1679803225
Name:KANAKIS, SORAYA JANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SORAYA
Middle Name:JANE
Last Name:KANAKIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34506 SE LINDEN LOOP
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9399
Mailing Address - Country:US
Mailing Address - Phone:425-888-0881
Mailing Address - Fax:
Practice Address - Street 1:526 228TH AVE NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7226
Practice Address - Country:US
Practice Address - Phone:425-868-1112
Practice Address - Fax:425-868-0170
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00039132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist