Individual
JAIME A NICACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
(360) 514-3142
(360) 514-6809
Mailing address
200 NE MOTHER JOSEPH PL, SUITE 100, VANCOUVER, WA 98664-3299
(360) 514-3142
(360) 514-6809
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
M-16759
ID
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD00038624
WA
Other
Enumeration date
10/24/2006
Last updated
12/19/2022
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