Provider Demographics
NPI:1609008101
Name:GILLUM, YURIKA TAKEMOTO (MSW)
Entity Type:Individual
Prefix:MRS
First Name:YURIKA
Middle Name:TAKEMOTO
Last Name:GILLUM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:YURIKA
Other - Middle Name:
Other - Last Name:TAKEMOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:15819 NE LEARY WAY APT D228
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4343
Mailing Address - Country:US
Mailing Address - Phone:206-852-5188
Mailing Address - Fax:
Practice Address - Street 1:15819 NE LEARY WAY APT D228
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4343
Practice Address - Country:US
Practice Address - Phone:206-852-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical