Provider Demographics
NPI:1811326556
Name:COTRONEO, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:COTRONEO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18336 AURORA AVE N
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4526
Mailing Address - Country:US
Mailing Address - Phone:206-533-1366
Mailing Address - Fax:
Practice Address - Street 1:18336 AURORA AVE N
Practice Address - Street 2:SUITE 112
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4526
Practice Address - Country:US
Practice Address - Phone:206-533-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60341221237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA203927545OtherEIN NUMBER