Russell Mikami

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT 00003614 Issued in WA

Legal business name

RUSSELL MIKAMI

Practice address

15413 E Valleyway Ave BLDG B-200
Spokane Valley, WA 99037-8554

Phone

(509) 928-3443

NPI assigned

Aug 18, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gloria Mikami

Title

Business Manager

Phone

(509) 928-3443

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lighthouse Physical Therapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell Mikami, P.T.

  • Specialist
  • Spokane Valley, WA
  • NPI 1225016488
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1851606586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15413 E VALLEYWAY AVE BLDG B-200",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378554",
            "telephone_number": "509-928-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15413 E VALLEYWAY AVE BLDG B-200",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378554",
            "telephone_number": "509-928-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL MIKAMI",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "MIKAMI",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "509-928-3443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT 00003614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7107527",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Kay Rudolph, LMP
• Dale R Ruemping, D.D.S. , M.S.D.
• Anupama R Ruiz, LMP
• Daidalus-Nikolai Soon Ruiz, RN
• Joanna Ruth Rusch, PHARM.D.
• Amanda Eve Russell, LMHC
• Paul E. Russell, MD
• Sarah Margaret Russell, PT
• Kathrin Leigh Russette, M.A., CCC-SLP
• Sydney A Rutherford, MSW

• Specialist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.