Provider Demographics
NPI:1174338099
Name:MCCONKIE, RYOKO MIYAGI
Entity type:Individual
Prefix:MS
First Name:RYOKO
Middle Name:MIYAGI
Last Name:MCCONKIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MOUNTAIN PARK BLVD SW APT E303
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3691
Mailing Address - Country:US
Mailing Address - Phone:206-931-0592
Mailing Address - Fax:
Practice Address - Street 1:208 MOUNTAIN PARK BLVD SW APT E303
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3691
Practice Address - Country:US
Practice Address - Phone:206-931-0592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZL-27018174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN