Provider Demographics
NPI:1053592097
Name:TSUNEMINE, YASUYO (LCSW)
Entity type:Individual
Prefix:
First Name:YASUYO
Middle Name:
Last Name:TSUNEMINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 NW LEAHY RD APT 310
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6385
Mailing Address - Country:US
Mailing Address - Phone:971-732-3307
Mailing Address - Fax:
Practice Address - Street 1:9601 NW LEAHY RD APT 310
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-6385
Practice Address - Country:US
Practice Address - Phone:971-732-3307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL43631041C0700X
WALW603477591041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical