Individual
DR. REX Z NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7320 216TH ST SW STE 320B, EDMONDS, WA 98026
(425) 775-6996
(425) 670-8905
Mailing address
7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
(425) 673-3900
(425) 673-3910
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO0000034O
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO00000340
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004092
—
WA
05
—
1009272
—
WA
01
—
81436
L&I
WA
01
—
PO0000034O
STATE LICENSE
WA
Enumeration date
09/22/2006
Last updated
06/13/2018
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