Individual
MS. JILLIAN MASAKO MITSUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
34600 12TH AVE SW, FEDERAL WAY, WA 98023-7060
(253) 945-3804
Mailing address
34816 1ST AVE S APT A515, FEDERAL WAY, WA 98003-6983
(253) 945-3804
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
610329E
WA
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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