Provider Demographics
NPI:1144258211
Name:NASH, SYLVIA RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:RUTH
Last Name:NASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 COOPER POINT RD SW
Mailing Address - Street 2:SUITE #140-308
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1107
Mailing Address - Country:US
Mailing Address - Phone:360-570-0636
Mailing Address - Fax:
Practice Address - Street 1:1001 COOPER POINT RD SW
Practice Address - Street 2:SUITE #140-308
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1107
Practice Address - Country:US
Practice Address - Phone:360-570-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23987207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ85160Medicare ID - Type Unspecified
AZC68224Medicare UPIN