Individual
NICOLE D COLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1450 5TH ST SE STE 3600, PUYALLUP, WA 98372-4665
(253) 841-4378
Mailing address
1450 5TH ST SE STE 3600, PUYALLUP, WA 98372-4665
(253) 841-4378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60313760
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD60313760
WA
207RP1001X
Pulmonary Disease Physician
36067
IA
207RP1001X
Pulmonary Disease Physician
Primary
MD60313760
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36067
STATE MEDICAL LICENSE
IA
Enumeration date
09/12/2007
Last updated
03/27/2013
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