Amy Lynn Nicholson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

CO61510344 Issued in WA

Practice address

9930 Evergreen Way Ste Z150
Everett, WA 98204-3889

Phone

(425) 347-5121

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1952025819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 W CASINO RD APT F206",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982048416",
            "telephone_number": "425-585-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 EVERGREEN WAY STE Z150",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043889",
            "telephone_number": "425-347-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CO61510344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Nichols, DPT
• Jami Lynn Nichols, CO61671418
• Jessica Pearle Nichols
• Lily Berry Nichols
• Malcolm Keith Nichols, LPC
• Erica Nicholson, LMT
• Vanessa Nicholson, M. D.
• Douglas Nickels
• Katie Nickol-Murphy, LMHCA
• Pamela Adrienne Nicoara, DDS, MSD

• Student in an Organized Health Care Education/Training Program in Everett, WA
• Providers in Everett, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.