1871844225 NPI number — MRS. HIROKA MAMIYA AU.D.

Table of content: MRS. HIROKA MAMIYA AU.D. (NPI 1871844225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871844225 NPI number — MRS. HIROKA MAMIYA AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAMIYA
Provider First Name:
HIROKA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
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:
1871844225
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1370 116TH AVE NE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98004-3825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-455-0526
Provider Business Mailing Address Fax Number:
425-818-9509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1370 116TH AVE NE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-3825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-455-0526
Provider Business Practice Location Address Fax Number:
425-818-9509
Provider Enumeration Date:
09/25/2012

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2033693 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: G8913197 . This is a "MEDICARFE PTAN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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