Provider Demographics
NPI:1295857746
Name:YAMAMOTO, AMYKO PEDERSEN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:AMYKO
Middle Name:PEDERSEN
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:F
Other - Last Name:YAMAMOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-764-2610
Mailing Address - Fax:206-764-2225
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2610
Practice Address - Fax:206-764-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW606143041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical