Nicholson Psychiatry, Pllc | |
11711 Se 8th St Ste 315 Bellevue WA 98005-3543 | |
(425) 245-5240 | |
(425) 962-8788 |
Full Name | Nicholson Psychiatry, Pllc |
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Speciality | Nurse Practitioner |
Location | 11711 Se 8th St Ste 315, Bellevue, Washington |
Authorized Official Name and Position | Jeanne Frances Nicholson (OWNER) |
Authorized Official Contact | 4252455240 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nicholson Psychiatry, Pllc Po Box 5268 Gulf Shores AL 36547-5268 Ph: (425) 414-9720 | Nicholson Psychiatry, Pllc 11711 Se 8th St Ste 315 Bellevue WA 98005-3543 Ph: (425) 245-5240 |
NPI Number | 1033706601 |
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Provider Enumeration Date | 12/29/2020 |
Last Update Date | 02/17/2023 |
Certification Date | 02/17/2023 |
Medicare PECOS PAC ID | 2860850302 |
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Medicare Enrollment ID | O20230615001560 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033706601 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Provider Name | Jeanne Frances Nicholson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568941706 PECOS PAC ID: 3779941216 Enrollment ID: I20230629002184 |
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