| Doctor Name: | DR. NICOLE M ANDERSON |
| NPI Number: | 1679824718 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ND, LMP |
| License Number: | MA60129767 |
| Business Practice Address: | 16923 96th Ave Ne Bothell, WA - 980111937 |
| Business Phone Number: | 4254292334 |
| Business Fax Number: | 4254837332 |
| Mailing Address: | Po Box 82765, KENMORE |
| State: | WA |
| Postal Code: | 980280765 |
| Phone Number: | 4254292334 |
| Fax Number: | 4254837332 |
| NPI Enumeration Date: | 09/28/2012 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | MA60129767 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |