Provider Demographics
NPI:1932242781
Name:TAKAMURA, YUMI (LMP)
Entity Type:Individual
Prefix:
First Name:YUMI
Middle Name:
Last Name:TAKAMURA
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 1:527 20TH AVE E
Mailing Address - Street 2:#3
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4056
Mailing Address - Country:US
Mailing Address - Phone:206-720-0466
Mailing Address - Fax:
Practice Address - Street 1:18920 BOTHELL WAY NE
Practice Address - Street 2:SUITE 204
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1981
Practice Address - Country:US
Practice Address - Phone:424-424-3730
Practice Address - Fax:425-424-2371
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA18505225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist