Healthcare Provider Details

I. General information

NPI: 1104982149
Provider Name (Legal Business Name): MONIQUE MARIE SOULIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W COURT ST
PASCO WA
99301
US

IV. Provider business mailing address

515 W COURT ST
PASCO WA
99301
US

V. Phone/Fax

Practice location:
  • Phone: 509-547-2204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN00147399
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN00147399
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: