Provider Demographics
NPI:1033706601
Name:NICHOLSON PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:NICHOLSON PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:425-245-5240
Mailing Address - Street 1:PO BOX 5268
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36547-5268
Mailing Address - Country:US
Mailing Address - Phone:425-414-9720
Mailing Address - Fax:425-962-8788
Practice Address - Street 1:11711 SE 8TH ST STE 315
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3543
Practice Address - Country:US
Practice Address - Phone:425-245-5240
Practice Address - Fax:425-962-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2023-02-17
Deactivation Date:2022-03-03
Deactivation Code:
Reactivation Date:2022-03-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty