Individual
AMY LYNN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9930 EVERGREEN WAY STE Z150, EVERETT, WA 98204-3889
(425) 347-5121
Mailing address
1926 W CASINO RD APT F206, EVERETT, WA 98204-8416
(425) 585-3470
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61510344
WA
Other
Enumeration date
10/03/2022
Last updated
07/15/2024
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