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1518250554
TIMOTHY ROBERT NICKOLAUS
RICHLAND, WA
NPI
1518250554
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: WA PA60217353)
Enumeration Date
2011-05-24
Last Update Date
2021-06-22
Business Address
TIMOTHY ROBERT NICKOLAUS PA
875 SWIFT BLVD
RICHLAND, WA 99352-3592
Phone number: 509-946-1654
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Mailing Address
TIMOTHY ROBERT NICKOLAUS PA
560 GAGE BLVD SUITE 203
RICHLAND, WA 99352
Phone number: 509-942-3627
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