Healthcare Provider Details

I. General information

NPI: 1275437394
Provider Name (Legal Business Name): EMILY SO RN,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S 43RD ST
RENTON WA
98055-5714
US

IV. Provider business mailing address

4809 PARKER RD E
SUMNER WA
98390-2825
US

V. Phone/Fax

Practice location:
  • Phone: 425-690-1000
  • Fax:
Mailing address:
  • Phone: 206-941-3693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: