Provider Demographics
NPI:1386909497
Name:SEWARD, NICOLE MARIE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:SEWARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10414 BEARDSLEE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:425-424-6305
Mailing Address - Fax:425-424-6381
Practice Address - Street 1:10414 BEARDSLEE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-424-6305
Practice Address - Fax:425-424-6381
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60212257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist