1598185613 NPI number — NADESHIKO WOMEN'S CLINIC, PLLC

Table of content: (NPI 1598185613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598185613 NPI number — NADESHIKO WOMEN'S CLINIC, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NADESHIKO WOMEN'S CLINIC, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NADESHIKO CLINIC PLLC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598185613
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11460 109TH AVE NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KIRKLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98033-4501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-354-6619
Provider Business Mailing Address Fax Number:
888-975-8077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13401 BEL-RED ROAD
Provider Second Line Business Practice Location Address:
A-12
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005-2322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-354-6619
Provider Business Practice Location Address Fax Number:
888-975-8077
Provider Enumeration Date:
04/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
OSHIO
Authorized Official First Name:
SACHIKO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, NURSE-PRACTITIONER
Authorized Official Telephone Number:
206-354-6619

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  AP30003584 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LW0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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