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
Phone: (425) 264-0660
Fax: (425) 264-0601
Website:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407858665 | NPPES |
| Washington | Other | P00301940 | RAILROAD MEDICARE |
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