1427205939 NPI number — DR. SONIA ANAND-NICHOLS MD

Table of content: DR. SONIA ANAND-NICHOLS MD (NPI 1427205939)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427205939 NPI number — DR. SONIA ANAND-NICHOLS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANAND-NICHOLS
Provider First Name:
SONIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANAND
Provider Other First Name:
SONIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427205939
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 760
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOX ISLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98333-0760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-539-8487
Provider Business Mailing Address Fax Number:
360-358-9944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8014 WARREN DR NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GIG HARBOR
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98335-6011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-539-8487
Provider Business Practice Location Address Fax Number:
360-358-9944
Provider Enumeration Date:
08/26/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  25MA09359700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0390593 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 118213600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".