Nickerson, Maureen Tara

Nickerson, Maureen Tara is an individual health care provider with primary practice located at 850 W. Maple St. , Medical Lake WA 99022. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Nickerson, Maureen Tara can be contacted via phone (509) 565-4000.

Contact Information

Primary practice address
850 W. Maple St. Medical Lake WA 99022
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY60778414 Washington

Profile Details

NPI number 1578130274
LBN Legal business name Nickerson, Maureen Tara
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2021
Last updated Jun 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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