Individual
NICOLE ENSLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HSP, SUDP
Contact information
Practice address
14090 FRYELANDS BLVD SE STE 347, MONROE, WA 98272-2760
(360) 805-3122
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0502
(206) 764-0516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
60553755
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61004872
WA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/18/2015
Last updated
10/15/2019
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