Provider Demographics
NPI:1982361101
Name:SOTO, LEOPOLDO (RT)
Entity Type:Individual
Prefix:
First Name:LEOPOLDO
Middle Name:
Last Name:SOTO
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344-1868
Mailing Address - Country:US
Mailing Address - Phone:903-422-1225
Mailing Address - Fax:
Practice Address - Street 1:620 ROSE DR
Practice Address - Street 2:
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344-1868
Practice Address - Country:US
Practice Address - Phone:903-422-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALR600609172278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care