# MR. NICHOLAS M REZEK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356329221
- **Gender:** Man
- **Credential:** PA C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004972 | WA | Yes |

## Other

- **Enumeration date:** 01/02/2006
- **Last updated:** 09/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0214542 | LIWA | WA |
| 01 | — | 3075RE | BSWA | WA |
| 05 | — | 8442725 | — | WA |