Provider Demographics
NPI:1770139131
Name:KOBAYASHI-KAJIWARA, JASMIN NOHEALANI (MS)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:NOHEALANI
Last Name:KOBAYASHI-KAJIWARA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JASMIN
Other - Middle Name:NOHEALANI
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2909 N PIONEER CANYON DR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-7505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2909 N PIONEER CANYON DR
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-7505
Practice Address - Country:US
Practice Address - Phone:808-489-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-1800235Z00000X
WALL61320782235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist