Healthcare Provider Details

I. General information

NPI: 1407319361
Provider Name (Legal Business Name): SONIA MALANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 EASTLAKE AVE E STE 115
SEATTLE WA
98102-3084
US

IV. Provider business mailing address

1526 NE 143RD ST APT 403
SEATTLE WA
98125-3243
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-1321
  • Fax:
Mailing address:
  • Phone: 270-929-3909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60949424
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: