Provider Demographics
NPI:1346757176
Name:FUJIWARA, TAMAMI
Entity Type:Individual
Prefix:
First Name:TAMAMI
Middle Name:
Last Name:FUJIWARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9757 NE JUANITA DR STE 214
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4291
Mailing Address - Country:US
Mailing Address - Phone:425-331-9772
Mailing Address - Fax:
Practice Address - Street 1:846 171ST PL NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-3758
Practice Address - Country:US
Practice Address - Phone:425-331-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61192826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health