Individual
DONNA JEAN NICKELBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6510 S FOUNTAIN PL, SEATTLE, WA 98178-2555
(206) 794-4574
Mailing address
6510 S FOUNTAIN PL, SEATTLE, WA 98178-2555
(206) 794-4574
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW 00009403
WA
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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