Provider Demographics
NPI:1144345406
Name:AIZAWA, AYAKO (MS)
Entity type:Individual
Prefix:MS
First Name:AYAKO
Middle Name:
Last Name:AIZAWA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 N 26TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-2406
Mailing Address - Country:US
Mailing Address - Phone:253-503-6761
Mailing Address - Fax:253-503-6925
Practice Address - Street 1:5702 N 26TH ST STE A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-2406
Practice Address - Country:US
Practice Address - Phone:253-503-6761
Practice Address - Fax:253-503-6925
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health