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Individual

ANNE E BLAKE-NICKELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, BA, AAC

Contact information

Practice address
2502 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3965
(360) 831-0904
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0502
(206) 764-0516

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG1472208
WA

Other

Enumeration date
08/02/2023
Last updated
08/02/2023
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