Healthcare Provider Details

I. General information

NPI: 1184608192
Provider Name (Legal Business Name): MR. ARIES MANALO SORIANO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 3RD AVE
SEATTLE WA
98101-2106
US

IV. Provider business mailing address

1223 147TH PL SW
LYNNWOOD WA
98087-6055
US

V. Phone/Fax

Practice location:
  • Phone: 206-624-1401
  • Fax: 206-624-3508
Mailing address:
  • Phone: 206-624-1401
  • Fax: 206-624-3508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberVA00051937
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: