Provider Demographics
NPI:1831439025
Name:HAKIEL, NICHOLAS (EDS)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:HAKIEL
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34332 SULTAN STARTUP RD
Mailing Address - Street 2:
Mailing Address - City:SULTAN
Mailing Address - State:WA
Mailing Address - Zip Code:98294-9670
Mailing Address - Country:US
Mailing Address - Phone:360-799-2313
Mailing Address - Fax:
Practice Address - Street 1:514 4TH ST
Practice Address - Street 2:
Practice Address - City:SULTAN
Practice Address - State:WA
Practice Address - Zip Code:98294-9474
Practice Address - Country:US
Practice Address - Phone:360-793-9831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA37116C174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist