Provider Demographics
NPI:1891162293
Name:NAGANO, HIROKO (MA)
Entity Type:Individual
Prefix:MRS
First Name:HIROKO
Middle Name:
Last Name:NAGANO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 125TH LN NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8762
Mailing Address - Country:US
Mailing Address - Phone:425-786-5090
Mailing Address - Fax:
Practice Address - Street 1:5704 125TH LN NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8762
Practice Address - Country:US
Practice Address - Phone:425-786-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60996161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health