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NICHOLAS WAYNE SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
2320 FREEWAY DR, MOUNT VERNON, WA 98273-5445
(360) 814-6800
(360) 814-6953
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA61352920
WA
363AS0400X
Surgical Physician Assistant
Primary
PA61352920
WA

Other

Enumeration date
09/16/2022
Last updated
11/18/2022
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