Nickoloff, Jonathan Matthew

Nickoloff, Jonathan Matthew is an individual health care provider with primary practice located at 9922 N Nevada St , Spokane WA 99218-1126. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Nickoloff, Jonathan Matthew can be contacted via phone (509) 747-6194.

Contact Information

Primary practice address
9922 N Nevada St Spokane WA 99218-1126
Phone: (509) 747-6194
Fax: (509) 838-0824
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00044271 Washington
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X MD00044271 Washington

Profile Details

NPI number 1891742664
LBN Legal business name Nickoloff, Jonathan Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Nov 29th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891742664 NPPES
Washington MEDICAID 8449159

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