Provider Demographics
NPI:1619345295
Name:ALLEN, NICHOLAS ANDREW (DNP, ARNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DNP, ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 ENSIGN RD NE
Mailing Address - Street 2:STE 220
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5063
Mailing Address - Country:US
Mailing Address - Phone:360-493-4001
Mailing Address - Fax:
Practice Address - Street 1:9213B ASHWORTH AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3501
Practice Address - Country:US
Practice Address - Phone:206-427-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-13
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60663487363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN60300150OtherWASHING STATE BOARD OF NURSING