Sunraksa Sylvester So

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00025378 Issued in WA

Practice address

812 39TH Ave SW Ste D
Puyallup, WA 98373-5915

Phone

(253) 841-2200

Fax

(253) 848-1075

NPI assigned

Mar 26, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Massage Me LLC

  • Clinic/Center
  • Puyallup, WA
  • NPI 1588443592
  NPD

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1265604573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5602 176TH ST E STE G102103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983759307",
            "telephone_number": "253-847-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 39TH AVE SW STE D",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735915",
            "telephone_number": "253-841-2200",
            "fax_number": "253-848-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "SUNRAKSA",
        "middle_name": "SYLVESTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-26",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00025378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Jonathan Snell, MD
• Snguyen & Lnguyen, PLLC
• Cecil E Snodgrass, M.D.
• Jeffrey Morris Snowking
• Sarah Evelyn Snyder, LMP
• Kalena Anna Soares-Kakulu, LMT
• Social Treatment Opportunity Programs II, Inc.
• Khushbu Sodhi Atwal, DO
• Scott John Soeder, LCO
• Jaymin Sohal, DO

• Specialist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.