Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60813965 | WA |
N | 2251P0200X | Physical Therapist - Pediatrics | 070016245 | IL |
NPI | 1013188515 |
---|---|
Provider Name | Ms. Takako Shiratori |
First Address | Glenview, IL 60026-8043 |
Second Address | Seattle, WA 98133-9008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2008 |
Last Update Date | 07/05/2018 |