Provider Demographics
NPI:1346894003
Name:NEILSEN, ASHTON
Entity Type:Individual
Prefix:MR
First Name:ASHTON
Middle Name:
Last Name:NEILSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:NEILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17825 59TH AVE NE STE B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6453
Mailing Address - Country:US
Mailing Address - Phone:360-363-4234
Mailing Address - Fax:
Practice Address - Street 1:17825 59TH AVE NE STE B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-6453
Practice Address - Country:US
Practice Address - Phone:360-363-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician