Provider Demographics
NPI:1164198255
Name:NEEF, NICK WILLIAM
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:WILLIAM
Last Name:NEEF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 PINE ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1403
Mailing Address - Country:US
Mailing Address - Phone:425-610-2075
Mailing Address - Fax:833-485-0483
Practice Address - Street 1:902 PINE ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1403
Practice Address - Country:US
Practice Address - Phone:425-610-2075
Practice Address - Fax:833-485-0483
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)