Provider Demographics
NPI:1689758609
Name:NAKADE, OSAMU (DDS)
Entity Type:Individual
Prefix:
First Name:OSAMU
Middle Name:
Last Name:NAKADE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 STRANDER BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2924
Mailing Address - Country:US
Mailing Address - Phone:206-575-8180
Mailing Address - Fax:206-575-8483
Practice Address - Street 1:411 STRANDER BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2924
Practice Address - Country:US
Practice Address - Phone:206-575-8180
Practice Address - Fax:206-575-8483
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist