MEDICARE: SOLE EXPRESSIONS

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
1	213E00000X	Podiatrist	PO00000743	WA

General Provider Information

NPI Number	:	1851338255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLE EXPRESSIONS

Provider Business Mailing Address
First Line	:	8015 SE 28TH ST
Second Line	:	SUITE 310
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2910
Country	:	US
Telephone Number	:	206-275-9705
Fax Number	:	425-484-6425

Provider Business Practice Location Address
First Line	:	8015 SE 28TH ST
Second Line	:	SUITE 310
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2910
Country	:	US
Telephone Number	:	206-275-9705
Fax Number	:	425-484-6425

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ERIKA G CARTER
Credential	:
Telephone Number	:	206-275-9705

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	08/22/2020

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