Provider Demographics
NPI:1689723652
Name:JOSEPH, SONIA M (LMP)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:M
Last Name:JOSEPH
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 1:16271 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-4424
Mailing Address - Country:US
Mailing Address - Phone:425-221-3845
Mailing Address - Fax:253-856-0990
Practice Address - Street 1:16271 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-4424
Practice Address - Country:US
Practice Address - Phone:425-221-3845
Practice Address - Fax:253-856-0990
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015514174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist