Organization
THURSTON EMERGENCY GROUP A PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN R NICHOLS MD (PRESIDENT)
(800) 893-9698
Entity
Organization
Contact information
Practice address
3900 CAPITOL MALL DR SW, OLYMPIA, WA 98502-8654
(360) 754-5858
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1092113
—
WA
Enumeration date
07/28/2008
Last updated
03/23/2022
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