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Individual

MASAKO KOMIYAMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW, ARNP

Contact information

Practice address
3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144
(206) 695-7600
(206) 695-7606
Mailing address
3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144-6847
(206) 695-7600
(206) 695-7606

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
743080021
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60994940
WA

Other

Enumeration date
10/15/2013
Last updated
10/10/2019
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