Individual
MR. ROBERT A NICACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
225 NE 4TH AVE, CAMAS, WA 98607-2125
(360) 834-2063
(360) 834-5375
Mailing address
912 MAIN ST, VANCOUVER, WA 98660-3136
(360) 694-6541
(360) 696-2578
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001808TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2023141
—
WA
Enumeration date
06/06/2006
Last updated
06/17/2013
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