Individual
NICHOLAS TAYLOR DULETZKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 NE 87TH AVE STE 301, VANCOUVER, WA 98664-1965
(360) 514-1854
(360) 514-6063
Mailing address
30 N 1900 E, SALT LAKE CITY, UT 84132-0002
(801) 581-6803
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD61281239
WA
2086S0102X
Surgical Critical Care Physician
MD61281239
WA
2086S0127X
Trauma Surgery Physician
Primary
MD61281239
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2016
Last updated
06/08/2022
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