Individual
SUSAN L NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
880 GUARD ST, FRIDAY HARBOR, WA 98250
(360) 317-6480
Mailing address
PO BOX 1433, FRIDAY HARBOR, WA 98250-1433
(360) 317-6480
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001892
WA
225XP0200X
Pediatric Occupational Therapist
OT00001892
WA
Other
Enumeration date
01/27/2010
Last updated
09/04/2014
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