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General NPI Number Information
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NPI Number | 1316253248
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Entity Type | Individual
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Provider Name | SONYA KOUSOUM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 13023 GREENWOOD AVE N
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City | SEATTLE
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State | WA
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Zip | 98133-7308
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Country | US
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Telephone | 206-365-4048
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Fax | 206-365-4096
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Provider Business Mailing Address
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Address Line | 304 SUMMIT AVE N
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City | KENT
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State | WA
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Zip | 98030-4714
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Country | US
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Telephone | 801-699-4019
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6092318-1701
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60167788
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License Number State | WA
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