Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 966 | NE |
N | 208000000X | Pediatrician | OP60948333 | WA |
N | 2080P0203X | Pediatric Critical Care Doctor | OP60948333 | WA |
N | 2080P0214X | Pediatric Pulmonologist | 966 | NE |
Y | 2080P0214X | Pediatric Pulmonologist | OP60948333 | WA |
NPI | 1083904775 |
---|---|
Provider Name | Dr. Nicholas Lee Friedman |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2011 |
Last Update Date | 16/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083904775 | (05) | WA |