Individual
NICOLE A HANNIBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1215 N MCDONALD RD STE 101, SPOKANE VALLEY, WA 99216-1557
(509) 598-7750
Mailing address
PO BOX 5299, MS: 820-5-PCO, TACOMA, WA 98415-0299
(253) 459-8009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OL61073038
WA
207Q00000X
Family Medicine Physician
Primary
OP61314799
WA
Other
Enumeration date
05/12/2020
Last updated
07/20/2023
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