Healthcare Provider Details

I. General information

NPI: 1437291382
Provider Name (Legal Business Name): MARGARET MARY NICHOLS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16125 JUANITA WOODINVILLE WAY NE UNIT 1806
BOTHELL WA
98011-6489
US

IV. Provider business mailing address

16125 JUANITA WOODINVILLE WAY NE UNIT 1806
BOTHELL WA
98011-6489
US

V. Phone/Fax

Practice location:
  • Phone: 425-487-9805
  • Fax:
Mailing address:
  • Phone: 425-487-9805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00005356
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: