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Sunraksa Sylvester So

Specialist β€’ Puyallup, WA

Active NPI 1265604573 Individual Practitioner Male Practitioner
Practice location in NPPES

812 39th Ave Sw Ste D
Puyallup, WA 983735915

Call 2538412200 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

812 39th Ave Sw Ste D

Puyallup, WA 983735915

Telephone 2538412200
Fax 2538481075
Organization at the Same NPPES Address or Phone
Southsound Treatment Massage Facility NPI 1245487347

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2008

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Puyallup and Washington

47 active clinicians are listed under Specialist with a practice address in Puyallup, WA (2,609 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Puyallup

0% of these 47 clinicians have the CMS telehealth indicator.

0% of these 47 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-09
Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

License # reported to NPPES WA MA00025378

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Business Mailing Address August 09, 2023

Registered at 5602 176TH ST E STE G102103, PUYALLUP, WA 983759307 (Tel: 2538477646)

βœ…
NPI Profile Active March 26, 2008

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 26, 2008

Registered at 812 39TH AVE SW STE D, PUYALLUP, WA 983735915 (Tel: 2538412200)

πŸ“
Business Mailing Address (Initial Record) March 26, 2008

Registered at 812 39TH AVE SW STE D, PUYALLUP, WA 983735915

πŸ‘€
Provider Name / Credentials (Initial Record) March 26, 2008

Recorded as SUNRAKSA SO

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2008

Specialist (license number reported to NPPES: WA MA00025378)

🟒
Initial NPI Registration & Enumeration March 26, 2008

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1265604573
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 26, 2008
Last Update: August 09, 2023
Sole Proprietor: Yes

Mailing Address

5602 176th St E Ste G102103

Puyallup, WA 983759307

Phone: 2538477646

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.