Provider Demographics
NPI:1417036930
Name:AUBLE, NICOLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:AUBLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 22ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-2065
Mailing Address - Country:US
Mailing Address - Phone:253-632-1336
Mailing Address - Fax:
Practice Address - Street 1:612 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2213
Practice Address - Country:US
Practice Address - Phone:206-244-1466
Practice Address - Fax:206-246-4636
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021008225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist