Individual
CLARA ANTIONETTE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
861 POPLAR PL S, SEATTLE, WA 98144-2827
(844) 987-9274
Mailing address
861 POPLAR PL S, SEATTLE, WA 98144-2827
(844) 987-9274
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60338711
WA
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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