Provider Demographics
NPI:1487169967
Name:ROY, NICHOLAS WILL (CFO)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:WILL
Last Name:ROY
Suffix:
Gender:M
Credentials:CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E CENTRAL AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6477
Mailing Address - Country:US
Mailing Address - Phone:509-326-6401
Mailing Address - Fax:509-325-5986
Practice Address - Street 1:212 E CENTRAL AVE STE 215
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6477
Practice Address - Country:US
Practice Address - Phone:509-326-6401
Practice Address - Fax:509-325-5986
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist