Kageyama, Nicole Prevo

Kageyama, Nicole Prevo is an individual health care provider with primary practice located at 1412 Sw 43Rd St Ste 205 , Renton WA 98057-4803. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Kageyama, Nicole Prevo can be contacted via phone (425) 264-0660.

Contact Information

Primary practice address
1412 Sw 43Rd St Ste 205 Renton WA 98057-4803
Fax: (425) 264-0601
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X MD00046078 Washington
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD00046078 Washington

Profile Details

NPI number 1407858665
LBN Legal business name Kageyama, Nicole Prevo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Sep 7th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407858665 NPPES
Washington Other P00301940 RAILROAD MEDICARE

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