MEDICARE: NICOLE ROSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA70012260	WA
2	101YM0800X	Mental Health Counselor	MC61691873	WA

General Provider Information

NPI Number	:	1184460206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ROSEN

Provider Business Mailing Address
First Line	:	2102 NE 50TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-3342
Country	:	US
Telephone Number	:	502-303-5160
Fax Number	:

Provider Business Practice Location Address
First Line	:	2102 NE 50TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-3342
Country	:	US
Telephone Number	:	502-303-5160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	09/15/2025

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Directions to “ NICOLE ROSEN ” Practice Location

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