Individual
NICOLE KATRINA JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
400 108TH AVE NE, OVERLAKE MEDICAL CLINIC, DOWNTOWN BELLEVUE, BELLEVUE, WA 98004
(425) 635-6350
Mailing address
400 108TH AVE NE, OVERLAKE MEDICAL CLINIC, DOWNTOWN BELLEVUE, BELLEVUE, WA 98004
(425) 635-6350
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP60508856
WA
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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