Provider Demographics
NPI:1831341205
Name:ALISHIO, SANAE ISHIMOTO (LMP)
Entity type:Individual
Prefix:
First Name:SANAE
Middle Name:ISHIMOTO
Last Name:ALISHIO
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 49TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2912
Mailing Address - Country:US
Mailing Address - Phone:206-696-4331
Mailing Address - Fax:
Practice Address - Street 1:2720 49TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2912
Practice Address - Country:US
Practice Address - Phone:206-696-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60042651225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist