Provider Demographics
NPI:1023296423
Name:SOLTERO, MONA L
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:L
Last Name:SOLTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 N. OLYMPIC AVE
Mailing Address - Street 2:STE. C
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8759
Mailing Address - Country:US
Mailing Address - Phone:360-403-3075
Mailing Address - Fax:360-403-3070
Practice Address - Street 1:436 N. OLYMPIC AVE
Practice Address - Street 2:STE. C
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-403-3075
Practice Address - Fax:360-403-3070
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00025283174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist