Individual
SANDRA J SOULEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
560 GAGE BLVD, SUITE 102, RICHLAND, WA 99352
(509) 942-3135
(509) 627-1188
Mailing address
3900 S ZINTEL WAY, KENNEWICK, WA 99338
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004233
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0242335
LABOR & INDUSTRIES
WA
05
—
1467543355
—
WA
Enumeration date
09/27/2006
Last updated
09/27/2013
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