Provider Demographics
NPI:1083607253
Name:NAKASHIMA, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:NAKASHIMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GIBBS LN
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-6226
Mailing Address - Country:US
Mailing Address - Phone:360-430-8401
Mailing Address - Fax:
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2367
Practice Address - Country:US
Practice Address - Phone:360-414-2700
Practice Address - Fax:360-414-2714
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036730207R00000X, 207RR0500X
MEMD23744207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110194827OtherRR MEDICARE
OR151283Medicaid
WA8922563OtherCRIME VICTIMS
WA8232464Medicaid
WA124241OtherLABOR & IND.
E39256Medicare UPIN
WA8232464Medicaid