Individual
SAMANTHA FUKUTAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
12040 NE 128TH ST, KIRKLAND, WA 98034-3013
(425) 899-1000
Mailing address
6011 121ST AVE SE, BELLEVUE, WA 98006-4468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61166507
WA
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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