Individual
NICHOLLAS JAMES BRUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1724 W UNION AVE STE 100, TACOMA, WA 98405-2099
(253) 830-5200
(253) 752-1160
Mailing address
7308 BRIDGEPORT WAY W STE 201, LAKEWOOD, WA 98499-8000
(253) 582-7257
(253) 582-1617
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
61148690
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2176684
—
WA
Enumeration date
03/09/2021
Last updated
05/11/2022
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