Charles R Souliere Jr., MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD00029182 Issued in WA

Practice address

700 Lilly Rd NE
Olympia, WA 98506-5115

Phone

(360) 923-7000

Fax

(360) 923-7089

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Franciscan Medical Group

  • Otolaryngology Physician
  • Tacoma, WA
  • NPI 1407805716
  NPD (past)
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1477999415
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1245288927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "SUITE 112",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-627-6731",
            "fax_number": "253-627-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000",
            "fax_number": "360-923-7089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Yakima Ave",
            "address_2": "Suite 112",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984055307",
            "country_code": "US",
            "telephone_number": "253-627-6731",
            "fax_number": "253-627-1064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOULIERE",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00029182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0223169",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1099951",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "208378",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00313076",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8941430",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0208377",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel Adam Sorensen, MSW
• Carol Johnson Sorenson, M.DIV
• Laurie T Sorenson, M.D.
• Luca Soto
• Julie Denise Sottilo-Brammeier, M.D.
• Sound Ambulatory Surgery Centers LLC
• Sound Apothecaries
• Sound Connection Audiology, LLC
• Sound E.N.T. Consultants, LLC
• Sound Heart Psychology, PLLC

• Otolaryngology Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.