Provider Demographics
NPI:1982416962
Name:SAKURA, MISHA YUKIKO
Entity type:Individual
Prefix:
First Name:MISHA
Middle Name:YUKIKO
Last Name:SAKURA
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 1:16 SPINNAKER LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-7942
Mailing Address - Country:US
Mailing Address - Phone:206-423-0999
Mailing Address - Fax:
Practice Address - Street 1:3533 CHUCKANUT DR
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:WA
Practice Address - Zip Code:98232-8564
Practice Address - Country:US
Practice Address - Phone:360-840-2248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist