Nicole R McCowan, MASSAGE PRACTITIONER

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00011293 Issued in WA

Practice address

1820 Black Lake Blvd SW
Suite 103
Olympia, WA 98512-5619

Phone

(360) 943-7665

Fax

(360) 357-4880

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467518944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4407",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985010407",
            "telephone_number": "360-943-7665",
            "fax_number": "360-357-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 BLACK LAKE BLVD SW",
            "address_2": "SUITE 103",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125619",
            "telephone_number": "360-943-7665",
            "fax_number": "360-357-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOWAN",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "MASSAGE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00011293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany F McConnell, LISCW
• Jennifer Alice McConnell
• Kristina Nicole McConnell, OT
• Timothy Michael McConnell, DC
• Cecilia McCormick
• Grace Gabrielle McCown
• Carol Jean McCulloch, RPH
• Edward Francis McCullough, D.C.
• Lisa McCullough, D.C.
• Madelaine Cathleen McCullough, PA-C

• Specialist in Olympia, WA
• Providers in Olympia, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.