Healthcare Provider Details

I. General information

NPI: 1770421653
Provider Name (Legal Business Name): MASAKI CARLTON RHODES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC ST BB-928
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 360-984-0626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMDRE.ML.70112937
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: