Individual
TERESA Y SOUCIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-3717
Mailing address
2819 26TH AVE W, SEATTLE, WA 98199-2817
(206) 301-9615
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4307222
—
MT
05
—
8435133
—
WA
Enumeration date
05/03/2006
Last updated
07/08/2007
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