Provider Demographics
NPI:1932178993
Name:SOO, ANDREW SINGTIONG (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SINGTIONG
Last Name:SOO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26136 PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032
Mailing Address - Country:US
Mailing Address - Phone:253-941-0887
Mailing Address - Fax:253-941-4642
Practice Address - Street 1:26136 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032
Practice Address - Country:US
Practice Address - Phone:253-941-0887
Practice Address - Fax:253-941-4642
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO619213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA607647300OtherUSPS WORKERS COMP
WA1110352Medicaid
WA0151953OtherDEPT OF LABOR & INDUSTRIE
WA5372SOOtherREGENCE RIDER NUMBER
WA8903622OtherCRIME VICTIM COMP
WA912000607OtherFED TAX ID
WA91200060798032A003OtherTRICARE
WA2805645OtherAETNA PROVIDER NUMBER
WA5242672OtherAETNA PROVIDER NUMBER
WAAB25407Medicare ID - Type Unspecified
WA5372SOOtherREGENCE RIDER NUMBER
WA0151953OtherDEPT OF LABOR & INDUSTRIE
WA5242672OtherAETNA PROVIDER NUMBER