Active NPI
Sandra J Soulek, PA
- Medical Physician Assistant
- Richland, WA
National Provider Identifier
1467543355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10004233
- Practice address
- 560 Gage Blvd
Suite 102
Richland, WA 99352 - Phone
- (509) 942-3135
- Fax
- (509) 627-1188
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10004233 | WA | Primary |
Addresses
Primary practice location
560 Gage Blvd
Suite 102
Richland, WA 99352
Mailing address
3900 S Zintel Way
Kennewick, WA 99338
Phone (509) 942-3627
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0242335 | Other | WA | LABOR & INDUSTRIES |
| 1467543355 | Medicaid | WA |
Other names 1
- Sandra Jean Ferris
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert J Marshall | Past | Accepting new patients |
Interoperability endpoints
- ssoulek1131082@wm.providencedirect.org
Organizations & group practices 1
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.
-
- Procedural Dermatology Physician
- Richland, WA
- NPI 1598848665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1467543355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 S ZINTEL WAY",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99338",
"telephone_number": "509-942-3627",
"fax_number": "509-942-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 GAGE BLVD",
"address_2": "SUITE 102",
"city": "RICHLAND",
"state": "WA",
"postal_code": "99352",
"telephone_number": "509-942-3135",
"fax_number": "509-627-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOULEK",
"first_name": "SANDRA",
"middle_name": "J",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10004233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0242335",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467543355",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "FERRIS",
"middle_name": "JEAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.