Individual
NICHOLE SUSAN CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
744 MARKET ST UNIT 102A, TACOMA, WA 98402-3700
(253) 272-9500
(253) 272-9501
Mailing address
440 ST HELENS AVE UNIT 303, TACOMA, WA 98402-2408
(253) 314-4656
(253) 272-9501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00021983
WA
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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