Individual
NICHOL T IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 3RD ST SE, SUITE 300, PUYALLUP, WA 98372-4511
(253) 697-5767
(253) 697-5682
Mailing address
1701 3RD ST SE, SUITE 300, PUYALLUP, WA 98372-4511
(253) 697-5767
(253) 697-5682
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00014336
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111661087
MEDICARE OTHER-INDIVIDUAL
WA
05
—
1410802
—
WA
01
—
193400000X
TAXONONMY
WA
01
—
CO3401
MEDICARE OTHER-GROUP
WA
Enumeration date
02/09/2006
Last updated
02/28/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us