Egerton Roy Nicholson, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH60112736 Issued in WA

Practice address

288 Martin St
105
Blaine, WA 98230-4045

Phone

(360) 603-4120

NPI assigned

Jan 4, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1205166840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 MARTIN ST",
            "address_2": "105",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982304045",
            "telephone_number": "360-603-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 MARTIN ST",
            "address_2": "105",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982304045",
            "telephone_number": "360-603-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "EGERTON",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH60112736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joo Yong Nam
• Kristy Faye Narkunas, LMP
• Aliya Nathani, PHARM.D.
• Leif Nesse
• Jill Newman
• Sonja Gunilla Norden, PHARM.D.
• Ashlynn Northouse, CBT
• Tiffany Olliver, PTA
• Tamara Olson
• Catherine Park

• Rehabilitation Chiropractor in Blaine, WA
• Providers in Blaine, WA by specialty
• Rehabilitation Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.