Individual
NICOLAS ALFONSO ELIZONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3110 COMMERCIAL AVE STE 105, ANACORTES, WA 98221-2762
(360) 336-3026
Mailing address
3110 COMMERCIAL AVE STE 105, ANACORTES, WA 98221-2762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA12784
TX
363A00000X
Physician Assistant
Primary
PA61067492
WA
Other
Enumeration date
04/09/2019
Last updated
12/29/2020
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