Provider Demographics
NPI:1124580360
Name:OKI, YUKINORI (MS ATC PES)
Entity Type:Individual
Prefix:
First Name:YUKINORI
Middle Name:
Last Name:OKI
Suffix:
Gender:M
Credentials:MS ATC PES
Other - Prefix:
Other - First Name:YUKI
Other - Middle Name:
Other - Last Name:OKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS ATC PES
Mailing Address - Street 1:12300 33RD AVE NE APT 303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5665
Mailing Address - Country:US
Mailing Address - Phone:203-675-0271
Mailing Address - Fax:
Practice Address - Street 1:3003 W CASINO RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-1910
Practice Address - Country:US
Practice Address - Phone:425-516-4159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1605763012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer