Individual
GREG I NAKAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19116 33RD AVE W, LYNNWOOD, WA 98036-4706
(425) 771-7500
Mailing address
1100 OLIVE WAY # MS /M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036474
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR AND INDUSTRIES #
WA
01
—
3328NA
BLUE SHIELD #
WA
05
—
8278137
—
WA
01
—
US7149247
AETNA SPECIALIST PIN
WA
Enumeration date
10/01/2006
Last updated
04/09/2008
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