Provider Demographics
NPI:1841586104
Name:NACEY, JAMES LOUIS (LMP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LOUIS
Last Name:NACEY
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 17TH AVE E
Mailing Address - Street 2:202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4655
Mailing Address - Country:US
Mailing Address - Phone:206-788-5169
Mailing Address - Fax:
Practice Address - Street 1:535 17TH AVE E
Practice Address - Street 2:202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4655
Practice Address - Country:US
Practice Address - Phone:206-788-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005985172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist