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Active NPI 1265604573 Individual Practitioner Male Practitioner

Sunraksa Sylvester So

Specialist • Puyallup, WA

Professional Overview & Biography Verified Profile Summary

Sunraksa So is a registered healthcare professional specializing in Specialist in Puyallup, WA. Practice services are available at 812 39TH AVE SW STE D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

812 39th Ave Sw Ste D

Puyallup, WA 983735915

Telephone 2538412200
Fax 2538481075
Associated Practice Facility / Clinic
🏢 Southsound Treatment Massage Facility NPI 1245487347

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Puyallup, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
49 Specialists

Practicing in Puyallup, WA (2751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-08-09
Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License 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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Amy Ottinger , LMP

Massage Therapist

NPI 1164767190

Licensed Massage Practitioner

NPI 1194057604

Licensed Massage Practitioner

Rachel Lynn , LMP

Massage Therapist

NPI 1396927380

Licensed Massage Practitioner

Ashley Kingston , LMP

Massage Therapist

NPI 1659786200

Licensed Massage Practitioner

Katherine Lurbiecki

Massage Therapist

NPI 1770132417
NPI 1770882342

Licensed Massage Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address August 09, 2023

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

NPI Profile Active March 26, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location March 26, 2008

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

📍
Updated Business Mailing Address March 26, 2008

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

👤
Provider Name / Credentials Updated March 26, 2008

Recorded as SUNRAKSA SO

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

Specialist (License #MA00025378 in WA)

🟢
Initial NPI Registration & Enumeration March 26, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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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

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.