1629153861 NPI number — DR. SETSUKO L MURAKAMI AU.D., CCC-A

Table of content: DR. SETSUKO L MURAKAMI AU.D., CCC-A (NPI 1629153861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629153861 NPI number — DR. SETSUKO L MURAKAMI AU.D., CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURAKAMI
Provider First Name:
SETSUKO
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D., CCC-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1629153861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3801 N 27TH ST UNIT 6918
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98407-5812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-262-6631
Provider Business Mailing Address Fax Number:
253-627-7575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4733 TACOMA MALL BLVD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98409-7110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-262-6631
Provider Business Practice Location Address Fax Number:
253-627-7575
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  LD60173725 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AU006WA , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1629153861 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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