Basic Information
| Provider Information | |||||||||
| NPI: | 1851318851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUY | ||||||||
| FirstName: | SOLY | ||||||||
| MiddleName: | RYAN | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PAC MMS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3909 CREEKSIDE LOOP | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989024880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486616 | ||||||||
| FaxNumber: | 5092484983 | ||||||||
| Practice Location | |||||||||
| Address1: | 3909 CREEKSIDE LOOP | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989024880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486616 | ||||||||
| FaxNumber: | 5092484983 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 09/10/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA 60107201 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 1068966 | 01 | CA | NCCPA NATIONAL COMMISSION | OTHER | WA 60107201 | 01 | WA | WASHINGTON STATE DEPARTMENT OF HEALTH | OTHER | PA18365 | 01 | CA | PHYSICIAN ASSISTANT COMMI | OTHER |