Provider Demographics
NPI:1548390032
Name:NOMURA, YASUSHI (ATC)
Entity Type:Individual
Prefix:MR
First Name:YASUSHI
Middle Name:
Last Name:NOMURA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 NW CLAY CT
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163
Mailing Address - Country:US
Mailing Address - Phone:509-332-7372
Mailing Address - Fax:509-335-4729
Practice Address - Street 1:WASHINGTON STATE UNIVERSITY
Practice Address - Street 2:BOHER GYM M4
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99164-1602
Practice Address - Country:US
Practice Address - Phone:509-335-3294
Practice Address - Fax:509-335-4729
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer