Provider Demographics
NPI:1699371278
Name:YOSHIMOTO, JUSTIN YUKIO (ARNP)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:YUKIO
Last Name:YOSHIMOTO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 TALBOT RD S STE 460
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5791
Mailing Address - Country:US
Mailing Address - Phone:425-690-3484
Mailing Address - Fax:425-690-9084
Practice Address - Street 1:4011 TALBOT RD S STE 460
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5791
Practice Address - Country:US
Practice Address - Phone:425-690-3484
Practice Address - Fax:425-690-9084
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61341985363L00000X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner