Petrochko, Nicholas

Petrochko, Nicholas is an individual health care provider with primary practice located at 9900 Se Sunnyside Rd , Clackamas OR 97015-9777. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Petrochko, Nicholas can be contacted via phone (503) 652-2880.

Contact Information

Primary practice address
9900 Se Sunnyside Rd Clackamas OR 97015-9777
Phone: (503) 652-2880
Fax: (503) 571-8984
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD010073 Tennessee

Profile Details

NPI number 1356352579
LBN Legal business name Petrochko, Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Feb 20th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356352579 NPPES
Tennessee Other 2000698 BLUE CROSS OF TENNESSEE
Tennessee MEDICAID 3013285 BLUE CROSS OF TENNESSEE
Tennessee Other 4535569 BLUE CROSS OF TENNESSEE

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