Individual
NICOLE SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1313 BROADWAY, TACOMA, WA 98402-3400
(253) 301-6400
Mailing address
4019 ELWOOD DR W, UNIVERSITY PLACE, WA 98466-1525
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN61245224
WA
Other
Enumeration date
09/26/2023
Last updated
07/10/2025
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