Healthcare Provider Details

I. General information

NPI: 1881833861
Provider Name (Legal Business Name): HIROHISA NAKAMAE M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE E
SEATTLE WA
98109-1023
US

IV. Provider business mailing address

1215 DEXTER AVE N APT 700
SEATTLE WA
98109-3567
US

V. Phone/Fax

Practice location:
  • Phone: 206-288-6956
  • Fax: 206-288-6956
Mailing address:
  • Phone: 206-352-5628
  • Fax: 206-352-5628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberFE 60066479
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: