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Individual
NICOLE BASSETT
Active
Individual
NICOLE BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
62352
OR
225100000X
Physical Therapist
Primary
—
WA
2251P0200X
Pediatric Physical Therapist
292334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500728132
—
OR
Enumeration date
01/16/2017
Last updated
01/09/2020
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