Individual
SUSAN LYNN NICHOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
11627 AIRPORT RD STE B, EVERETT, WA 98204-8714
(425) 248-4900
Mailing address
5729 156TH ST SW, EDMONDS, WA 98026-4617
(206) 612-3852
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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