Individual
KEYANA NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3436 MARY ELDER RD NE, OLYMPIA, WA 98506-5050
(360) 528-2590
Mailing address
5010 4TH WAY SW APT 202, OLYMPIA, WA 98502-2408
(706) 801-2627
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60927578
WA
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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