Healthcare Provider Details

I. General information

NPI: 1780458083
Provider Name (Legal Business Name): MIKIYO OHASHI NC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 136TH PL NE STE 100
BELLEVUE WA
98005-2343
US

IV. Provider business mailing address

1800 136TH PL NE STE 100
BELLEVUE WA
98005-2343
US

V. Phone/Fax

Practice location:
  • Phone: 425-800-5557
  • Fax: 866-987-4204
Mailing address:
  • Phone: 425-800-5557
  • Fax: 866-987-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberNC60472559
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: