Individual
NICOLE ROCHELLE BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 631-3011
Mailing address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60495445
WA
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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