Individual
NICHOLE WEBBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1218 N DIVISION AVE, SITE 102, SANDPOINT, ID 83864-5054
(208) 304-0652
Mailing address
PO BOX 2546, SANDPOINT, ID 83864-0917
(208) 304-0652
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60728364
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT60728364
WASHINGTON OCCUPATIONAL THERAPY LICENSE
WA
Enumeration date
02/20/2017
Last updated
02/20/2017
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