Provider Demographics
NPI:1134327489
Name:NELSON, JAMES ALONZO (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALONZO
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 NE WINDERMERE RD
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2857
Mailing Address - Country:US
Mailing Address - Phone:206-523-4546
Mailing Address - Fax:206-522-6084
Practice Address - Street 1:5655 NE WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2857
Practice Address - Country:US
Practice Address - Phone:206-523-4546
Practice Address - Fax:206-522-6084
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMDOOO24355171W00000X
WAMD00024355174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171W00000XOther Service ProvidersContractor