MASAKO KOMIYAMA (NPI# 1790113413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790113413 |
| Entity Type | Individual |
| Full Name | MASAKO KOMIYAMA |
| Credential | LICSW, ARNP |
| Practice Address |
3639 Martin Luther King Jr Way S Seattle WA 98144 |
| Mailing Address |
3639 Martin Luther King Jr Way S Seattle WA 98144-6847 |
| Practice Telephone | 2066957600 |
| Practice Fax Number | 2066957606 |
| Mailing Telephone | 2066957600 |
| Mailing Fax Number | 2066957606 |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2019-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
743080021 | WA | Behavioral Health & Social Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP60994940 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10212 5th Ave Ne Ste 150, Seattle, WA 981257473 | 2064180600 | 2064180612 |
| 2600 Sw Holden St, Seattle, WA 981263505 | 2062488226 |
| Street Address |
3639 MARTIN LUTHER KING JR WAY S |
| City | SEATTLE |
| State | WA |
| Zip Code | 98144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821106824 | Evan David Kanter | Psychiatry & Neurology | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2006-08-29 |
| 1346841681 | Sorphorn Thoam | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-11-03 |
| 1912508565 | Kyle Ernst | Assistant Behavior Analyst | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-11-02 |
| 1225638455 | Jennifer Kwok | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-10-27 |
| 1992311823 | Jibran A Ahmed | Registered Nurse | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-09-16 |
| 1346855491 | Phuong Thi-ngoc Nguyen | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-09-14 |
| 1013526896 | Sean Robert Reardon | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-07-28 |
| 1154930089 | Christopher Nestor Batalon | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-07-27 |
| 1548879430 | Christine Sohn | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-07-27 |
| 1700494036 | May Tam | Counselor | 3639 Martin Luther King Jr Way S, Seattle, WA 98144-6847 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558975235 | Miranda Plummer | Counselor | 2122 S Jackson Street, Seattle, WA 98144 | 2020-09-01 |
| 1891337457 | Alyson Paris | Counselor | 2100 24th Ave S, Suite 260, Seattle, WA 98144 | 2019-10-15 |
| 1912558370 | Marco Antonio Medina Sotelo | Counselor | 113 23rd Avenue South, Seattle, WA 98144 | 2019-09-26 |
| 1952865909 | John Thomas Hogan | Counselor | 1600 S Lane, Seattle, WA 98144 | 2019-01-23 |
| 1134693856 | Kimo Martin | Peer Specialist | 1600 Lane St, Seattle, WA 98144 | 2019-01-15 |
| 1952875791 | Rainier Chiropractic Accident and Injury Ps | Massage Therapist | 2326 Rainier Ave S, Ste B, Seattle, WA 98144 | 2019-01-15 |
| 1174097083 | Seann M Combs | Counselor | 1600 S Lane St, Seattle, Wa 98144, Seattle, WA 98144 | 2019-01-14 |
| 1922571587 | Cristina Wirkala | Registered Nurse | Crisis Solutions Center, 1600 South Lane Street, Seattle, WA 98144 | 2019-01-07 |
| 1215405162 | Vickie Barron | Counselor | 3401 Rainier Ave S, Suite B, Seattle, WA 98144 | 2018-11-08 |
| 1164906509 | Julie Seddon Cabell | Counselor | Central Youth and Family Services, 1901 Mlk Jr Way S., Seattle, WA 98144 | 2018-09-21 |
| Find all providers in zip 98144 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747213 | Peaceful Coexistence, LLC | Nurse Practitioner | 4730 University Way Ne Ste 104, Seattle, WA 98105-4424 | 2020-07-16 |
| 1326668856 | Healing Heart Therapeutic Services | Nurse Practitioner | 1915 2nd Ave Apt 2212, Seattle, WA 98101-3165 | 2020-04-24 |
| 1588297444 | Rosalie Francesca Gammelgaard | Nurse Practitioner | 4106 Midvale Ave N, Seattle, WA 98103-7916 | 2020-02-19 |
| 1992343669 | Laurel Kristine Tronsen | Nurse Practitioner | 1959 Ne Pacific St # 104, Seattle, WA 98195-0001 | 2019-12-12 |
| 1043855471 | Mountain Peak Mental Health, Pllc | Nurse Practitioner | 155 Ne 100th St Ste 220, Seattle, WA 98125-8015 | 2019-11-08 |
| 1356907885 | Virtual Allied Remote Diagnostic and Clinical Services | Nurse Practitioner | 800 Fairview Ave N, Seattle, WA 98109-4412 | 2019-05-09 |
| 1003382763 | Shannon Troy Presler | Nurse Practitioner | 5941 California Ave Sw Apt 105, Seattle, WA 98136-1665 | 2018-10-21 |
| 1629550215 | Lance Edward Briggs | Nurse Practitioner | 5306 Ballard Ave Nw Ste 208, Seattle, WA 98107-4366 | 2018-08-30 |
| 1912400797 | Mackenzie Kampa | Nurse Practitioner | 505 Nw 60th St, Seattle, WA 98107-2143 | 2018-03-17 |
| 1265941975 | Rachel Jacks | Nurse Practitioner | 2428 Nw Market St Apt 410, Seattle, WA 98107-4171 | 2017-09-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.