Provider Demographics
NPI:1649592809
Name:NAKANO, RIEKO (LMP)
Entity Type:Individual
Prefix:
First Name:RIEKO
Middle Name:
Last Name:NAKANO
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 WESTLAKE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5217
Mailing Address - Country:US
Mailing Address - Phone:206-749-5253
Mailing Address - Fax:206-749-4049
Practice Address - Street 1:235 WESTLAKE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5217
Practice Address - Country:US
Practice Address - Phone:206-749-5253
Practice Address - Fax:206-749-4049
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60055656225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist