Provider Demographics
NPI:1962591479
Name:KUNIYOSHI, CATHERINE JACKSON (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JACKSON
Last Name:KUNIYOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 WESTERN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3500
Mailing Address - Country:US
Mailing Address - Phone:206-405-3600
Mailing Address - Fax:206-405-3604
Practice Address - Street 1:1501 WESTERN AVE STE 110
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3500
Practice Address - Country:US
Practice Address - Phone:206-405-3600
Practice Address - Fax:206-405-3604
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000464702084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry