Individual
NIEKOL MARTINNE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
(509) 665-6065
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 665-6065
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60184705
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0299262
L&I
WA
01
—
0299265
L&I
WA
01
—
0299267
L&I
WA
01
—
0299269
L&I
WA
01
—
0299271
L&I
WA
01
—
G8911562
MEDICARE
WA
01
—
G8911563
MEDICARE
WA
Enumeration date
10/27/2010
Last updated
10/11/2013
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