Individual
DR. NICHOLAS RAY SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 W 5TH AVE, SPOKANE, WA 99204-2803
(509) 473-7672
Mailing address
PO BOX 21040, SPOKANE, WA 99201-7197
(509) 473-7672
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2005004445
MO
207L00000X
Anesthesiology Physician
Primary
MD60974769
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336
MO-BLUE SHIELD
—
05
—
930820174
—
MO
Enumeration date
07/17/2006
Last updated
01/04/2020
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