Provider Demographics
NPI:1588421994
Name:TATSUNAMI, SHIHO SHEILA (ATC)
Entity type:Individual
Prefix:
First Name:SHIHO
Middle Name:SHEILA
Last Name:TATSUNAMI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 N 10TH PL APT 2224
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5660
Mailing Address - Country:US
Mailing Address - Phone:206-437-0708
Mailing Address - Fax:
Practice Address - Street 1:1901 OAKESDALE AVE SW
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2623
Practice Address - Country:US
Practice Address - Phone:206-437-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1606430882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer