MEDICARE: OSAMU NAKADE DDS

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	122300000X	Dentist	DE00009638	WA

General Provider Information

NPI Number	:	1689758609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAMU NAKADE DDS

Provider Business Mailing Address
First Line	:	411 STRANDER BLVD
Second Line	:	SUITE 207
City	:	TUKWILA
State	:	WA
Zip	:	98188-2924
Country	:	US
Telephone Number	:	206-575-8180
Fax Number	:	206-575-8483

Provider Business Practice Location Address
First Line	:	411 STRANDER BLVD
Second Line	:	SUITE 207
City	:	TUKWILA
State	:	WA
Zip	:	98188-2924
Country	:	US
Telephone Number	:	206-575-8180
Fax Number	:	206-575-8483

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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