Individual
NICOLE BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E FOURTH PLAIN BLVD BLDG 5, VANCOUVER, WA 98661-3717
(971) 940-0313
Mailing address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3713
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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