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General NPI Number Information
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NPI Number | 1790643468
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Entity Type | Individual
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Provider Name | NICOLE SERVIS
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 6307 CALIFORNIA AVE SW STE 101
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City | SEATTLE
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State | WA
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Zip | 98136-1853
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Country | US
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Telephone | 206-790-4027
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Fax |
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Provider Business Mailing Address
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Address Line | 12532 SE 32ND ST UNIT 37
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City | BELLEVUE
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State | WA
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Zip | 98005-4372
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Country | US
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Telephone | 206-790-4027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | WA
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