Healthcare Provider Details

I. General information

NPI: 1508630799
Provider Name (Legal Business Name): AGNIESZKA KATARZYNA SOBOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23475 NE NOVELTY HILL RD
REDMOND WA
98053-5501
US

IV. Provider business mailing address

23475 NE NOVELTY HILL RD
REDMOND WA
98053-5501
US

V. Phone/Fax

Practice location:
  • Phone: 425-636-0440
  • Fax: 425-636-0443
Mailing address:
  • Phone: 425-636-0440
  • Fax: 425-636-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61429167
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH.61429167
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: