Provider Demographics
NPI:1649414418
Name:MANCERA SOTO, FELICIA NICOLE (LPN)
Entity type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:NICOLE
Last Name:MANCERA SOTO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 16TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5226
Mailing Address - Country:US
Mailing Address - Phone:206-326-4545
Mailing Address - Fax:206-326-4555
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-4545
Practice Address - Fax:206-326-4555
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2024-12-27
Deactivation Date:2024-05-24
Deactivation Code:
Reactivation Date:2024-06-10
Provider Licenses
StateLicense IDTaxonomies
WALP60163061164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse