Provider Demographics
NPI:1740980895
Name:RAZWICK, NICHOLLE ANN (ND)
Entity type:Individual
Prefix:
First Name:NICHOLLE
Middle Name:ANN
Last Name:RAZWICK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:NICKY
Other - Middle Name:ANN
Other - Last Name:RAZWICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:32724 SE 44TH ST
Mailing Address - Street 2:
Mailing Address - City:FALL CITY
Mailing Address - State:WA
Mailing Address - Zip Code:98024-8724
Mailing Address - Country:US
Mailing Address - Phone:206-954-5943
Mailing Address - Fax:
Practice Address - Street 1:1000 2ND AVE STE 2920
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1094
Practice Address - Country:US
Practice Address - Phone:206-966-4522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60310861175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA12345OtherNONMEDICARE