Provider Demographics
NPI:1538821897
Name:WANG, SOPHIA SHAO YU
Entity type:Individual
Prefix:MISS
First Name:SOPHIA
Middle Name:SHAO YU
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SOFIA
Other - Middle Name:MILENE
Other - Last Name:ON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHCA
Mailing Address - Street 1:100 N HOWARD ST STE R
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0508
Mailing Address - Country:US
Mailing Address - Phone:206-450-4373
Mailing Address - Fax:
Practice Address - Street 1:720 SENECA ST STE 107221
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2764
Practice Address - Country:US
Practice Address - Phone:206-450-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61356295101YM0800X
WALH61667954101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health