Provider Demographics
NPI:1790948255
Name:SOON, ANNY (MD)
Entity Type:Individual
Prefix:
First Name:ANNY
Middle Name:
Last Name:SOON
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 1:7320 216TH ST SW
Mailing Address - Street 2:#200
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-640-4900
Mailing Address - Fax:
Practice Address - Street 1:7320 216TH ST SW
Practice Address - Street 2:#200
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8006
Practice Address - Country:US
Practice Address - Phone:425-640-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-04
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60208374207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine