Provider Demographics
NPI:1538742960
Name:PINGREE, SOFIA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:PINGREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18224 56TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-4559
Mailing Address - Country:US
Mailing Address - Phone:520-600-9398
Mailing Address - Fax:
Practice Address - Street 1:18224 56TH ST NE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-4559
Practice Address - Country:US
Practice Address - Phone:520-600-9398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician