Healthcare Provider Details
I. General information
NPI: 1386447845
Provider Name (Legal Business Name): SOPHIA ELIAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/31/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 SAND POINT WAY NE OC.7.830
SEATTLE WA
98105
US
IV. Provider business mailing address
4800 SAND POINT WAY NE OC.7.830
SEATTLE WA
98105
US
V. Phone/Fax
- Phone: 206-987-2352
- Fax:
- Phone: 206-987-2352
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ML61681889 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: