Provider Demographics
NPI:1164747200
Name:NIKOLOVA, SONIA L (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:L
Last Name:NIKOLOVA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E HAMLIN ST
Mailing Address - Street 2:APT 3
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3142
Mailing Address - Country:US
Mailing Address - Phone:206-660-0417
Mailing Address - Fax:
Practice Address - Street 1:2106 2ND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2215
Practice Address - Country:US
Practice Address - Phone:206-441-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60138724363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60138724OtherWASHINGTON STATE DEPARTMENT OF HEALTH