Healthcare Provider Details

I. General information

NPI: 1093113714
Provider Name (Legal Business Name): MICHAEL OKADA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2014
Last Update Date: 12/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 140TH AVE NE STE 100
BELLEVUE WA
98005-4571
US

IV. Provider business mailing address

10501 8TH AVE NE APT 131
SEATTLE WA
98125-7252
US

V. Phone/Fax

Practice location:
  • Phone: 425-746-2475
  • Fax:
Mailing address:
  • Phone: 808-895-9972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 60499251
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: