Provider Demographics
NPI:1477979292
Name:OGASAWARA-WHITEHEAD, MAMI (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:MAMI
Middle Name:
Last Name:OGASAWARA-WHITEHEAD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:OGASAWARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:600 OAKESDALE AVE SW
Mailing Address - Street 2:STE 104
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5226
Mailing Address - Country:US
Mailing Address - Phone:425-228-5336
Mailing Address - Fax:425-228-4540
Practice Address - Street 1:600 OAKESDALE AVE SW
Practice Address - Street 2:STE 104
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5226
Practice Address - Country:US
Practice Address - Phone:425-228-5336
Practice Address - Fax:425-228-4540
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60043920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health