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General NPI Number Information
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NPI Number | 1740355403
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Entity Type | Individual
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Provider Name | JOSHUA HERBERT NELSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 2211 E MILL PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98661-9926
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Country | US
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Telephone | 360-418-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 1122 NE 64TH AVE
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City | PORTLAND
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State | OR
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Zip | 97213-4912
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Country | US
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Telephone | 971-404-5971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD26581
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD60144258
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License Number State | WA
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