Individual
NICHOLE LYNN PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
1016 COMMERCIAL ST, RAYMOND, WA 98577-2631
(360) 942-3271
Mailing address
PO BOX 1530, ABERDEEN, WA 98520-0265
(360) 533-9750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60786018
WA
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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