Provider Demographics
NPI:1770121725
Name:SONI, MUNLEEN K (LAC)
Entity type:Individual
Prefix:
First Name:MUNLEEN
Middle Name:K
Last Name:SONI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 SE RASMUSSEN BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-8618
Mailing Address - Country:US
Mailing Address - Phone:360-798-5704
Mailing Address - Fax:
Practice Address - Street 1:1207 SE RASMUSSEN BLVD STE 119
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-8618
Practice Address - Country:US
Practice Address - Phone:360-798-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR187539171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty