Provider Demographics
NPI:1548391170
Name:OTO, KAORI (LMT)
Entity Type:Individual
Prefix:
First Name:KAORI
Middle Name:
Last Name:OTO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4331 FRANCIS AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7117
Mailing Address - Country:US
Mailing Address - Phone:206-369-2212
Mailing Address - Fax:
Practice Address - Street 1:9706 4TH AVE NE STE 303
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-302-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
WAMA00015027225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist