Individual
ASHLEY MARIE NICKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
19505 44TH AVE W, SUITE A, LYNNWOOD, WA 98036-5658
(206) 375-3100
Mailing address
19505 44TH AVE W, SUITE A, LYNNWOOD, WA 98036-5658
(206) 375-3100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60280120
WA
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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