MEDICARE: JACIE KEIKO SHIMAMOTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1861362667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACIE KEIKO SHIMAMOTO

Provider Business Mailing Address
First Line	:	3410 W WHISTALKS WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99224-5204
Country	:	US
Telephone Number	:	509-903-6967
Fax Number	:

Provider Business Practice Location Address
First Line	:	3410 W WHISTALKS WAY
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99224-5204
Country	:	US
Telephone Number	:	509-903-6967
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	12/01/2025

Similar Medicare Providers

1871002477 — PHOEBE DUKE ATC, AT/L
Practice Location Address:

3410 W FORT GEORGE WRIGHT DR
SPOKANE, WA
99224-5204

Practice Phone: 509-533-3640
Practice Fax:

1356205116 — UNFILTERED MENTAL HEALTH THERAPY, PLLC
Practice Location Address:

3836 W GRANDVIEW AVE.
SPOKANE, WA
99224

Practice Phone: 509-850-0112
Practice Fax:

1457215147 — JACK ELLIOTT
Practice Location Address:

1960 N HOLY NAMES CT FL 3
SPOKANE, WA
99224-5803

Practice Phone: 509-242-2308
Practice Fax:

1346104049 — JOEL FRANK ALLEN
Practice Location Address:

1960 N HOLY NAMES CT FL 3
SPOKANE, WA
99224-5803

Practice Phone: 509-242-2308
Practice Fax:

1740927359 — MOLLY RIDDLE
Practice Location Address:

1700 S ASSEMBLY RD STE 300
SPOKANE, WA
99224-2116

Practice Phone: 509-892-9241
Practice Fax: 509-892-9251

1598628117 — CEDAR BRANCH COUNSELING, LLC
Practice Location Address:

3895 W CLIFFSIDE LN
SPOKANE, WA
99224-6202

Practice Phone: 208-220-4754
Practice Fax:

Directions to “ JACIE KEIKO SHIMAMOTO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.