Individual
NICHOLAS MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
380 CHASE AVE, WALLA WALLA, WA 99362-2924
(509) 897-3790
Mailing address
380 CHASE AVE, WALLA WALLA, WA 99362-2924
(509) 897-2299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
3592
WV
208600000X
Surgery Physician
Primary
OP61466777
WA
Other
Enumeration date
05/04/2015
Last updated
10/25/2023
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