Provider Demographics
NPI:1982371944
Name:ACOSTA, NICHOLL JOANN MARIE (CPC)
Entity Type:Individual
Prefix:MS
First Name:NICHOLL
Middle Name:JOANN MARIE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:NICHOLL
Other - Middle Name:JOANN MARIE
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NICHOLL ALASPA
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-0502
Mailing Address - Fax:206-764-0516
Practice Address - Street 1:6221 NE FOURTH PLAIN BLVD APT 130
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7210
Practice Address - Country:US
Practice Address - Phone:360-831-0908
Practice Address - Fax:360-952-8641
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor