Individual
DR. CHRISTOPHER MEAD NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6002 WESTGATE BLVD, SUITE 160, TACOMA, WA 98406-2570
(253) 759-4522
(253) 759-4699
Mailing address
6002 WESTGATE BLVD, SUITE 160, TACOMA, WA 98406-2570
(253) 759-4522
(253) 759-4699
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
2005026727
MO
208200000X
Plastic Surgery Physician
Primary
MD00049126
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0272224
STATE L&I
WA
05
—
8510752
—
WA
01
—
G8873979
MEDICARE
WA
Enumeration date
09/16/2006
Last updated
04/06/2011
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