Individual
SUNRAKSA SYLVESTER SO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
812 39TH AVE SW STE D, PUYALLUP, WA 98373-5915
(253) 841-2200
(253) 848-1075
Mailing address
5602 176TH ST E STE G102103, PUYALLUP, WA 98375-9307
(253) 847-7646
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00025378
WA
Other
Enumeration date
03/26/2008
Last updated
08/09/2023
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