Provider Demographics
NPI:1619197753
Name:KAKUTANI, TOMOKO (LAC, MS)
Entity Type:Individual
Prefix:MS
First Name:TOMOKO
Middle Name:
Last Name:KAKUTANI
Suffix:
Gender:F
Credentials:LAC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11515 26TH AVE NE APT 303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15650 NE 24TH ST STE C2
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2460
Practice Address - Country:US
Practice Address - Phone:206-353-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002558171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist