Provider Demographics
NPI:1841169109
Name:ITAMI, KERRY (DACHM, LAC, EAMP)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:ITAMI
Suffix:
Gender:F
Credentials:DACHM, LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20006 CEDAR VALLEY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20006 CEDAR VALLEY RD STE 203
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6334
Practice Address - Country:US
Practice Address - Phone:707-931-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAACUP.AC.70043130171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist