Provider Demographics
NPI:1548245053
Name:OKAMURA, SANDRA MIEKO (RPH)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:MIEKO
Last Name:OKAMURA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12742 17TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4104
Mailing Address - Country:US
Mailing Address - Phone:206-365-6746
Mailing Address - Fax:
Practice Address - Street 1:18420 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4416
Practice Address - Country:US
Practice Address - Phone:206-542-2948
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00016311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist