Provider Demographics
NPI:1841327582
Name:KAISER, NICHOLE DAWN (ATC)
Entity type:Individual
Prefix:MR
First Name:NICHOLE
Middle Name:DAWN
Last Name:KAISER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E TIETON AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1119
Mailing Address - Country:US
Mailing Address - Phone:509-468-4269
Mailing Address - Fax:
Practice Address - Street 1:523 E TIETON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1119
Practice Address - Country:US
Practice Address - Phone:509-468-4269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer