Individual
NICOLE R MCCOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE PRACTITIONER
Contact information
Practice address
1820 BLACK LAKE BLVD SW, SUITE 103, OLYMPIA, WA 98512-5619
(360) 943-7665
(360) 357-4880
Mailing address
PO BOX 4407, TUMWATER, WA 98501-0407
(360) 943-7665
(360) 357-4880
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00011293
WA
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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