Healthcare Provider Details

I. General information

NPI: 1124580360
Provider Name (Legal Business Name): YUKINORI OKI MS. ATC. PES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: YUKI OKI MS. ATC. PES

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 09/11/2025
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 W CASINO RD
EVERETT WA
98204-1910
US

IV. Provider business mailing address

12300 33RD AVE NE APT 303
SEATTLE WA
98125-5665
US

V. Phone/Fax

Practice location:
  • Phone: 425-516-4159
  • Fax:
Mailing address:
  • Phone: 203-675-0271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA160576301
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: