Most Relevant Information
Provider Data
| NPI Number: | 1003126913 |
| Provider Name: | DOUGLAS NICKELS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/13/2010 |
| Last Updated: | 10/13/2010 |
Provider Practice Location
4027 HOYT AVE
EVERETT
WA
982014972
Practice Location Phone/Fax
| Phone: | 4252590966 |
| Fax: |
Provider Mailing Location
PO BOX 5127
EVERETT
WA
982065127
Provider Mailing Phone/Fax
| Phone: | 4252583903 |
| Fax: |