MEDICARE: DR. NICHOLAS DOWNEY FREUEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	60378265	WA

General Provider Information

NPI Number	:	1790959377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS DOWNEY FREUEN DDS

Provider Business Mailing Address
First Line	:	101 W CASCADE WAY STE 103
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6000
Country	:	US
Telephone Number	:	509-468-1535
Fax Number	:	509-467-6372

Provider Business Practice Location Address
First Line	:	101 W CASCADE WAY STE 103
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6000
Country	:	US
Telephone Number	:	509-468-1535
Fax Number	:	509-467-6372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	10/16/2013

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