Individual
KYLE JIRO MATSUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
12040 NE 128TH ST # MS 103, KIRKLAND, WA 98034-3013
(425) 866-0358
Mailing address
12040 NE 128TH ST # MS 103, KIRKLAND, WA 98034-3013
(425) 866-0358
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60952587
WA
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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