Individual
NICOLE MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPS
Contact information
Practice address
2212 S JACKSON ST, SEATTLE, WA 98144-2591
(206) 329-6485
Mailing address
2212 S JACKSON ST, SEATTLE, WA 98144-2591
(206) 329-6485
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WA
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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