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MATHEW A NICHOLLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11695 NE 4TH ST, BELLEVUE, WA 98004-5268
(425) 637-1855
Mailing address
1100 9TH AVE, M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
36058
KY
207X00000X
Orthopaedic Surgery Physician
Primary
MD60713968
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000335141
BCBS
KY
05
64077316
KY
01
7995543
AETNA
KY
Enumeration date
06/09/2006
Last updated
07/23/2020
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