Individual
NICHOLE KAYLEEN KUNKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1128 BROADWAY ST, LONGVIEW, WA 98632-3831
(360) 669-9018
Mailing address
1128 BROADWAY ST, LONGVIEW, WA 98632-3831
(360) 669-9018
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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