Healthcare Provider Details

I. General information

NPI: 1275731200
Provider Name (Legal Business Name): NICOLAS RAY CAHANDING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 33100
APO AE
09180-3100
US

IV. Provider business mailing address

CMR 402 BOX 405
APO AE
09180-0005
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-7805
  • Fax:
Mailing address:
  • Phone: 253-339-6507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOP60043616
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberQ8840
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberOP60043616
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberOP60043616
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberQ8840
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberQ8840
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: