Healthcare Provider Details

I. General information

NPI: 1841743770
Provider Name (Legal Business Name): MASUMI OKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 109TH AVE NE
BELLEVUE WA
98004-4404
US

IV. Provider business mailing address

929 109TH AVE NE
BELLEVUE WA
98004-4404
US

V. Phone/Fax

Practice location:
  • Phone: 425-326-1545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA61034829
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: