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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. BRUCE RODERICK NIELSON

Active Sole Proprietor

MR. BRUCE RODERICK NIELSON is a Medical Laboratory Technician healthcare provider located in RIDGEFIELD, Washington. NPI 1043600836 is currently active in the NPPES registry. Verify at CMS.

Medical Laboratory Technician · RIDGEFIELD, WA

Registration Details

NPI Number
1043600836
Provider Type
Individual
Gender
Male
NPI Issued
Jan 30, 2015 (11.350833298998 yrs)
Last Updated
Jan 30, 2015
Licenses
ST00001996 (WA)
XT00004606 (WA)
MA00153098 (WA)
NA00153098 (WA)
Sole Proprietor
Yes

Practice Information

Address
415 NE 194TH ST
UNIT 1
RIDGEFIELD, WA, 986429496
Browse WA providers · Browse ZIP 98642
Phone
3609361096
Fax
4252169433
Primary Specialty
Medical Laboratory Technician
246ZS0410X
Additional Specialty
Radiologic Technologist
Additional Specialty
Nurse's Aide
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.