Provider Demographics
NPI:1003083973
Name:BUTTERFIELD, NICOLE LYNN (DC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 NW GROPPER RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:WA
Mailing Address - Zip Code:98648-6254
Mailing Address - Country:US
Mailing Address - Phone:541-581-0691
Mailing Address - Fax:877-352-3485
Practice Address - Street 1:375 NW GROPPER RD
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:WA
Practice Address - Zip Code:98648-6254
Practice Address - Country:US
Practice Address - Phone:541-581-0691
Practice Address - Fax:877-352-3485
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-10
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009339111N00000X
KS01-05111111N00000X
MO2007008728111N00000X
OR5602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor