Healthcare Provider Details

I. General information

NPI: 1942136064
Provider Name (Legal Business Name): LILLIE'S SOULFUL PLATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4634 E MARGINAL WAY S STE E120
SEATTLE WA
98134-2328
US

IV. Provider business mailing address

766 GARFIELD ST APT 302
SEATTLE WA
98109-3053
US

V. Phone/Fax

Practice location:
  • Phone: 206-465-1213
  • Fax:
Mailing address:
  • Phone: 206-465-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MRS. ASHLEY WILLIAMS
Title or Position: CEO/OWNER
Credential:
Phone: 206-465-1213