| Doctor Name: | MS. NICOLETTE CAMACHO |
| NPI Number: | 1902297856 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | 60475834 |
| Business Practice Address: | 100 Tatoosh Pl Steilacoom, WA - 983881444 |
| Business Phone Number: | 2535836235 |
| Business Fax Number: | 2535810552 |
| Mailing Address: | 100 Tatoosh Pl, STEILACOOM |
| State: | WA |
| Postal Code: | 983881444 |
| Phone Number: | 2535836235 |
| Fax Number: | 2535810552 |
| NPI Enumeration Date: | 02/13/2015 |
| NPI Last Update Date: | 02/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 60475834 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |