Wannarachue, Nikom
Wannarachue, Nikom is an individual health care provider with primary practice located at 721 S Auburn St , Kennewick WA 99336-5665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wannarachue, Nikom can be contacted via phone (509) 586-1157.Contact Information
Primary practice address
721 S Auburn St
Kennewick WA 99336-5665
Phone: (509) 586-1157
Fax: (509) 582-4189
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00012028 | Washington |
Profile Details
| NPI number | 1205936028 |
|---|---|
| LBN Legal business name | Wannarachue, Nikom |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205936028 | NPPES |
| Washington | MEDICAID | 1915008 |
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