MEDICARE: REID NAKAGAWA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH60483545	WA

General Provider Information

NPI Number	:	1043611437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REID NAKAGAWA PHARMD

Provider Business Mailing Address
First Line	:	1001 MERCER ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4324
Country	:	US
Telephone Number	:	206-223-0658
Fax Number	:	206-512-8169

Provider Business Practice Location Address
First Line	:	1001 MERCER ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4324
Country	:	US
Telephone Number	:	206-223-0658
Fax Number	:	206-512-8169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2014
Last Update Date	:	09/04/2014

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