Individual
DR. NICHOLAS JAMES THEMELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11601 PACIFIC AVE S, TACOMA, WA 98444-5435
(253) 536-3336
(253) 536-3242
Mailing address
11601 PACIFIC AVE S, TACOMA, WA 98444-5435
(253) 536-3336
(253) 536-3242
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00025303
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018430
—
WA
01
—
TH0534
REGENCE BLUESHIELD
WA
Enumeration date
10/19/2006
Last updated
06/24/2010
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