Provider Demographics
NPI:1164682654
Name:OKUZAWA, NANA (MD)
Entity Type:Individual
Prefix:DR
First Name:NANA
Middle Name:
Last Name:OKUZAWA
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 1:3639 MARTIN LUTHER KING JR WAY S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-6847
Mailing Address - Country:US
Mailing Address - Phone:206-695-7600
Mailing Address - Fax:206-695-7606
Practice Address - Street 1:3639 MARTIN LUTHER KING JR WAY S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-6847
Practice Address - Country:US
Practice Address - Phone:206-695-7600
Practice Address - Fax:206-695-7606
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1383152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD00040385OtherLICENSE