Individual
MR. SAMUAL ALLEN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-4971
Mailing address
948 E 39TH AVE, SPOKANE, WA 99203-3035
(509) 747-2697
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
30007381
WA
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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