Individual
MS. SONYA A COTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10004 204TH AVE E, # 3400, BONNEY LAKE, WA 98391-6539
(253) 848-5951
(253) 845-7073
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 845-7073
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004726
WA
363AM0700X
Medical Physician Assistant
PA10004726
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0192968
LABOR AND INDUSTRIES
WA
01
—
3908CO
REGENCE RIDER
WA
05
—
8410540
—
WA
01
—
P00220748
MEDICARE RAIL ROAD
WA
Enumeration date
06/04/2006
Last updated
01/25/2016
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