Healthcare Provider Details

I. General information

NPI: 1417539651
Provider Name (Legal Business Name): SONYA TARYN GLEICHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 116TH AVE NE STE 500
BELLEVUE WA
98004-4627
US

IV. Provider business mailing address

1135 116TH AVE NE STE 500
BELLEVUE WA
98004-4627
US

V. Phone/Fax

Practice location:
  • Phone: 425-709-7055
  • Fax:
Mailing address:
  • Phone: 425-709-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number70160630
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: