Individual
MS. NICOLE KEENA NEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 9TH AVE, MS-M4-PFS, SEATTLE, WA 98101-2756
(206) 223-6374
Mailing address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60188378
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568771400
—
WA
Enumeration date
09/27/2010
Last updated
04/02/2012
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