Provider Demographics
NPI:1306063409
Name:UEDA, EIKO
Entity type:Individual
Prefix:MS
First Name:EIKO
Middle Name:
Last Name:UEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19711 112TH AVE NE
Mailing Address - Street 2:C306
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-1774
Mailing Address - Country:US
Mailing Address - Phone:206-276-2359
Mailing Address - Fax:
Practice Address - Street 1:12951 BEL RED RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2644
Practice Address - Country:US
Practice Address - Phone:206-276-2359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023621225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist