Provider Demographics
NPI:1588915920
Name:OKADA, TOMOKO (MOT)
Entity type:Individual
Prefix:MS
First Name:TOMOKO
Middle Name:
Last Name:OKADA
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 S FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1300
Mailing Address - Country:US
Mailing Address - Phone:253-383-0617
Mailing Address - Fax:
Practice Address - Street 1:11812 MUNDY LOSS RD
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-9351
Practice Address - Country:US
Practice Address - Phone:360-829-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003233225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist