Healthcare Provider Details

I. General information

NPI: 1437004645
Provider Name (Legal Business Name): NATHAN TANA WAYNE ONG TANIGAMI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SE 27TH ST STE 100
MERCER ISLAND WA
98040-3087
US

IV. Provider business mailing address

7800 SE 27TH ST STE 100
MERCER ISLAND WA
98040-3087
US

V. Phone/Fax

Practice location:
  • Phone: 206-216-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP.AP.70166269-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: