Healthcare Provider Details

I. General information

NPI: 1710840186
Provider Name (Legal Business Name): NICHOLE SEYMANSKI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 WOODLAND SQUARE LOOP SE STE B-7
OLYMPIA WA
98503-1000
US

IV. Provider business mailing address

1420 MARVIN RD NE STE C
LACEY WA
98516-3878
US

V. Phone/Fax

Practice location:
  • Phone: 253-590-5192
  • Fax:
Mailing address:
  • Phone: 253-590-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLE M. SEYMANSKI
Title or Position: OWNER
Credential: PSY.D.
Phone: 253-590-5192