Individual
NICHOLAS ANDREW JUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7401 W HOOD PL STE 200, KENNEWICK, WA 99336-3400
(509) 591-0070
Mailing address
7401 W HOOD PL STE 200, KENNEWICK, WA 99336-3400
(509) 591-0070
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Q8523
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD60751696
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2079915
—
WA
Enumeration date
06/18/2012
Last updated
07/21/2022
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