Healthcare Provider Details

I. General information

NPI: 1679456362
Provider Name (Legal Business Name): SHOMA OKITA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14800 STARFIRE WAY
TUKWILA WA
98188-8502
US

IV. Provider business mailing address

14800 STARFIRE WAY
TUKWILA WA
98188-8502
US

V. Phone/Fax

Practice location:
  • Phone: 206-267-7811
  • Fax: 206-267-7813
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: