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General NPI Number Information
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NPI Number | 1457408221
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Entity Type | Organization
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Legal Business Name | PACIFIC OTOLARYNGOLOGY PS
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 1901 S UNION AVE B-2010
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City | TACOMA
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State | WA
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Zip | 98405-1702
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Country | US
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Telephone | 253-627-4502
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Fax | 253-627-4465
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Provider Business Mailing Address
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Address Line | 1901 S UNION AVE B-2010
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City | TACOMA
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State | WA
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Zip | 98405-1702
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Country | US
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Telephone | 253-627-4502
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Fax | 253-627-4465
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS JAMES HAMILL
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Credential | M.D.
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Telephone | 253-627-4502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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