| Doctor Name: | MISS JAMIE LEIALOHA SHIMABUKU |
| NPI Number: | 1093097461 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., CCC/SLP |
| License Number: | LL60223112 |
| Business Practice Address: | 22443 Se 240th St B101 Maple Valley, WA - 98038 |
| Business Phone Number: | 4253587160 |
| Business Fax Number: | 4253587159 |
| Mailing Address: | 22443 Se 240th St, B101 MAPLE VALLEY |
| State: | WA |
| Postal Code: | 98038 |
| Phone Number: | 4253587160 |
| Fax Number: | 4253587159 |
| NPI Enumeration Date: | 09/12/2011 |
| NPI Last Update Date: | 07/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | LL60223112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |