Organization
ENDC PLLC
Active
Other names
Evergreen Nerodevelopmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE MARIE BAIN PHD MA MED (PSYCHOLOGIST/OWNER)
(425) 753-5001
Entity
Organization
Contact information
Practice address
19217 36TH AVE W. SUITE 219, LYNNWOOD, WA 98036
(425) 753-5001
(425) 412-3960
Mailing address
P.O. BOX 635, MUKILTEO, WA 98275
(425) 753-5001
(425) 412-3960
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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