Healthcare Provider Details

I. General information

NPI: 1831588441
Provider Name (Legal Business Name): NICOLE IWUOHA-THOMAS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S 320TH ST
FEDERAL WAY WA
98003-4691
US

IV. Provider business mailing address

4301 NE 4TH ST # 3306
RENTON WA
98059-9997
US

V. Phone/Fax

Practice location:
  • Phone: 206-956-9570
  • Fax: 206-448-8495
Mailing address:
  • Phone: 206-853-5085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60512133
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: