Koike arrived in Seattle in 1916 at the age of 38, and established a medical clinic in the downtown area near Main Street and 5th Avenue.

He was a participant in the first Frederick & Nelson art salon, noted for his pictorialist style, and innovative combination of an Eastern and Western aesthetic.

His solo exhibitions included the Kodak Park Camera Club, Rochester, NY, 1926, the Portage Camera Club, Akron, Ohio, 1927, the Brooklyn Institute of Arts & Sciences in 1928, and The Art Institute of Seattle in 1929.

Given his thriving practice in the Japanese community in Seattle, his professional income allowed him not only to concentrate on his photography but to underwrite many of the expenses of forming the club.

He was a member of the Rainier Ginsha, a Seattle Haiku poetry society formed in 1934 by poet Kyōu Kawajiri.