Provider Demographics
NPI:1184982407
Name:SIMERLY, SONNI ERIKA (PA-C)
Entity type:Individual
Prefix:
First Name:SONNI
Middle Name:ERIKA
Last Name:SIMERLY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SONNI
Other - Middle Name:ERIKA
Other - Last Name:RYCHLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:801 BROADWAY
Practice Address - Street 2:SUITE 617
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4396
Practice Address - Country:US
Practice Address - Phone:206-623-0922
Practice Address - Fax:206-623-1588
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA157572363AS0400X
WAPA60656069363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2022378Medicaid
WA383912OtherWA LABOR & INDUSTRIES
OR500645348Medicaid