Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nishant Gautam

Individual provider Family Medicine Physician · NPI 1295416741

Nishant Gautam is a Family Practice in Longview, Washington. Qualified in 2015, 11 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Washington.

Years since qualifying
11
Licensed in
WA
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1718 E Kessler Blvd
Longview, WA 98632-1842
Phone: (360) 747-5800
Fax: (360) 575-3846
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4864 Jackson St, Monroe, LA 71202-6400 — (318) 330-7600

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD70045885 (WA)

Record details

NPI number1295416741
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 27, 2023
Last updated in NPPESMay 6, 2026
Certification dateMay 6, 2026
Mailing address4864 Jackson St, Monroe, LA 71202-6400

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Longview