Healthcare Provider Details
I. General information
NPI: 1881033371
Provider Name (Legal Business Name): NICHOLAS PATRICK STRASSER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2013
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16201 E INDIANA AVE STE 5300
SPOKANE VALLEY WA
99216-1882
US
IV. Provider business mailing address
PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US
V. Phone/Fax
- Phone: 509-530-5240
- Fax: 509-891-4088
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OP60738448 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | OP60738446 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: