Provider Demographics
NPI:1538996962
Name:THE SOPHIA WAY
Entity type:Organization
Organization Name:THE SOPHIA WAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMOUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-436-7843
Mailing Address - Street 1:1100 BELLEVUE WAY NE # 8A-110
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4280
Mailing Address - Country:US
Mailing Address - Phone:425-463-6285
Mailing Address - Fax:
Practice Address - Street 1:11061 NE 2ND ST STE 223
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5810
Practice Address - Country:US
Practice Address - Phone:425-463-6285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health