Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 1023598265 | WA |
NPI | 1023598265 |
---|---|
Provider Name | Nikolus Remington Richey |
First Address | Spokane, WA 99224-5347 |
Second Address | Spokane, WA 99224-5347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2018 |
Last Update Date | 01/06/2020 |