Healthcare Provider Details

I. General information

NPI: 1952265811
Provider Name (Legal Business Name): KAN ABRAHAM SAKURAGI LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 166TH AVE NE STE D140
REDMOND WA
98052-7853
US

IV. Provider business mailing address

1205 100TH PL NE
BELLEVUE WA
98004-3511
US

V. Phone/Fax

Practice location:
  • Phone: 425-472-2516
  • Fax:
Mailing address:
  • Phone: 425-829-4572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number60933190
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: