Individual
MRS. NICHOLE LEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC - PTA
Contact information
Practice address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(503) 570-3665
Mailing address
16521 NE 29TH ST, VANCOUVER, WA 98682-8673
(360) 944-5208
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8244
OR
225200000X
Physical Therapy Assistant
P160334499
WA
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
03/24/2007
Last updated
06/20/2019
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