Provider Demographics
NPI:1669718755
Name:MCCOY VALREY, SONJA (DDS)
Entity type:Individual
Prefix:DR
First Name:SONJA
Middle Name:
Last Name:MCCOY VALREY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 131ST ST S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-4804
Mailing Address - Country:US
Mailing Address - Phone:253-539-7445
Mailing Address - Fax:253-539-7538
Practice Address - Street 1:130 131ST ST S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4804
Practice Address - Country:US
Practice Address - Phone:253-539-7445
Practice Address - Fax:253-539-7538
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8568122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist