Provider Demographics
NPI:1871844225
Name:MAMIYA, HIROKA (AUD)
Entity Type:Individual
Prefix:MRS
First Name:HIROKA
Middle Name:
Last Name:MAMIYA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 116TH AVE NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3825
Mailing Address - Country:US
Mailing Address - Phone:425-455-0526
Mailing Address - Fax:425-818-9509
Practice Address - Street 1:1370 116TH AVE NE
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3825
Practice Address - Country:US
Practice Address - Phone:425-455-0526
Practice Address - Fax:425-818-9509
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2033693Medicaid
WAG8913197OtherMEDICARFE PTAN