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NPI Code Detail

MEDICARE: ANDREW SOU DO

MEDICARE: ANDREW SOU DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianOP60963789WA
2207R00000XInternal Medicine PhysicianA20218CA
3207RI0200XInfectious Disease PhysicianA20218CA

General Provider Information

NPI Number : 1770955361
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW SOU DO
Provider Business Mailing Address
First Line : 26004 104TH AVE SE STE 101
Second Line :
City : KENT
State : WA
Zip : 98030-7677
Country : US
Telephone Number : 425-251-4040
Fax Number :
Provider Business Practice Location Address
First Line : 26004 104TH AVE SE STE 101
Second Line :
City : KENT
State : WA
Zip : 98030-7677
Country : US
Telephone Number : 425-251-4040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2015
Last Update Date : 04/09/2026

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Directions to “ ANDREW SOU DO” Practice Location

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