Individual
NICHOLAS PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
302 5TH ST STE 3, CLARKSTON, WA 99403-1803
(509) 769-2211
(509) 769-2210
Mailing address
1922 POWERS DR, LEWISTON, ID 83501-6043
(208) 305-0467
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
10344697-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
10344697-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2014
Last updated
07/11/2022
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