Individual
NICOLAS TODD BRISTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(360) 628-2968
Mailing address
5232 54TH AVE SE, LACEY, WA 98503-9007
(360) 628-2968
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60653580
WA
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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