Individual provider Active NPI

Nana Okuzawa, MD

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1164682654
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
138315 Issued in CA
Practice address
3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Phone
(206) 695-7600
Fax
(206) 695-7606
NPI assigned
Jun 10, 2008
Last updated
Oct 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 138315 CA Primary

Addresses

Primary practice location

3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847

Mailing address

3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Phone (206) 695-7600

Other practice location 1

614 Tully Rd
San Jose, CA 95111-1048
Phone (408) 494-1561

Other identifiers 1

IdentifierTypeStateIssuer
MD00040385OtherWALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170727001429 WA Practitioner - Psychiatry 8628209699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
138315CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Counseling and Referral Service CurrentSince Apr 30, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

655 156th Ave SE
Ste 255
Bellevue, WA 98007
Phone (206) 695-7511

3639 Mlk Jr Way S
Seattle, WA 98144
Phone (206) 695-7637

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1164682654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MARTIN LUTHER KING JR WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446847",
            "telephone_number": "206-695-7600",
            "fax_number": "206-695-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 MARTIN LUTHER KING JR WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446847",
            "telephone_number": "206-695-7600",
            "fax_number": "206-695-7606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "614 Tully Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951111048",
            "country_code": "US",
            "telephone_number": "408-494-1561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKUZAWA",
        "first_name": "NANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "138315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD00040385",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.