Provider Demographics
NPI:1790070076
Name:KADOHIRO, CAREY YURI
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:YURI
Last Name:KADOHIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 S 37TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7473
Mailing Address - Country:US
Mailing Address - Phone:253-671-6002
Mailing Address - Fax:253-671-6009
Practice Address - Street 1:2219 S 37TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7473
Practice Address - Country:US
Practice Address - Phone:253-671-6002
Practice Address - Fax:253-671-6009
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60159403183500000X
HIPH-3140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist