Provider Demographics
NPI:1710080775
Name:EGUCHI, JUNE (LMP)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:
Last Name:EGUCHI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 ATLAS PLACE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136
Mailing Address - Country:US
Mailing Address - Phone:206-923-2299
Mailing Address - Fax:206-923-2254
Practice Address - Street 1:6025 ATLAS PL SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136
Practice Address - Country:US
Practice Address - Phone:206-923-2299
Practice Address - Fax:206-923-2254
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00003706225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist