Individual
DR. NOBUYOSHI KAGEYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1412 SW 43RD ST, SUITE 205, RENTON, WA 98057-4803
(425) 264-0660
(425) 264-0601
Mailing address
1200 112TH AVE NE STE C187, BELLEVUE, WA 98004-3749
(425) 457-7900
(425) 457-7499
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
L4999
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0715KA
BLUE SHIELD #
WA
05
—
8457582
—
WA
01
—
P00341277
RAILROAD MC #
WA
01
—
US7949137
ATENA SPECIALIST PIN
WA
Enumeration date
10/06/2005
Last updated
07/21/2022
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