Individual
SCOTT ANTHONY NICOLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
1601 E FOURTH PLAIN BLVD STE A212, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
3105 NE 105TH CIR, VANCOUVER, WA 98686-3976
(360) 600-6806
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
03/08/2023
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