Provider Demographics
NPI:1063773190
Name:KATO, HISAO (LMP)
Entity type:Individual
Prefix:MR
First Name:HISAO
Middle Name:
Last Name:KATO
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 116TH AVE NE
Mailing Address - Street 2:#100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3800
Mailing Address - Country:US
Mailing Address - Phone:425-956-4123
Mailing Address - Fax:
Practice Address - Street 1:1260 116TH AVE NE
Practice Address - Street 2:#100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3800
Practice Address - Country:US
Practice Address - Phone:425-956-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60282374225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist