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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MOSOPE SODA MD
NPI 1003600719
Student in an Organized Health Care Education/Training Program in Tacoma, WA

Active since April 07, 2025PECOS Enrolled
1202 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405(253) 441-4742 Get Directions Write a Review

NPPES record last updated: June 26, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 20, 2025, May 22, 2025, Apr 7, 2025 (3 updates tracked since 2025).

About Mosope Soda Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOSOPE SODA MD (NPI 1003600719) is an individual student in an organized health care education/training program in Tacoma, Washington and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003600719
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMOSOPE SODACredential: MD
Location Address1202 MARTIN LUTHER KING JR WAYTacoma, WA 98405-3926
Mailing Address4207 Kitsap WayBremerton, WA 98312-2447
Phone(253) 441-4742
Sole ProprietorNo
Enumeration DateApril 7, 2025
Last NPPES UpdateJune 26, 20263 updates tracked since enumeration
NPPES CertifiedJune 26, 2026
✔ NPI 1003600719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1202 MARTIN LUTHER KING JR WAY, Tacoma, WA 98405
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mosope Soda Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNY AN NGUYEN RDH
Dental Hygienist
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 441-4743
JENNIE LI YANG
Student in an Organized Health Care Education/Training Program
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 441-4742
LETICIA MOSS
Dental Hygienist
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 441-4743
ELIZABETH MARIE COOK DO
Student in an Organized Health Care Education/Training Program
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 441-4742
SEAN GEORGE DO
Student in an Organized Health Care Education/Training Program
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 441-4742
MARIELYS PORTAL CRESPO
Student in an Organized Health Care Education/Training Program
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 441-4742
ANDREA OHM NP
Nurse Practitioner (Family)
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 597-4550
JOSEPHINE ESHUN NP
Nurse Practitioner (Family)
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Pierce County (253) 597-4550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mosope Soda's NPI number?

The NPI number for Mosope Soda is 1003600719. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Where is Mosope Soda located?

Mosope Soda practices at 1202 Martin Luther King Jr Way, Tacoma, WA 98405. The listed phone number is (253) 441-4742.

What is Mosope Soda's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mosope Soda enrolled in Medicare?

Yes. Mosope Soda is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mosope Soda was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.