Katlin Michele Nicholson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60941291 Issued in WA

Practice address

432 NE Ravenna Blvd
Unit 101
Seattle, WA 98115-8448

Phone

(206) 524-4977

Fax

(206) 524-4340

NPI assigned

Apr 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Seattle Rehab Specialists, Inc.

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1780114033
  Medicare reassignment
• Multicare Health System

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1154818326
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1992267876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 NE RAVENNA BLVD",
            "address_2": "UNIT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158448",
            "telephone_number": "206-524-4977",
            "fax_number": "206-524-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 NE RAVENNA BLVD",
            "address_2": "UNIT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158448",
            "telephone_number": "206-524-4977",
            "fax_number": "206-524-4340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 W Ann Arbor Trl Ste 220",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481706224",
            "country_code": "US",
            "telephone_number": "866-991-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "KATLIN",
        "middle_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34419",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60941291",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shierry Weber Nicholsen, L.M.H.C.
• Bradley L. Nicholson, MD
• Carol Jean Nicholson, OTRL, CHT
• Carrie Erica Nicholson
• Cornelius Adolphus Nicholson, DDS
• Martha Nicholson, LMT
• Micah Aaron Nicholson, DDS
• Tristan Marriner Nicholson, MD, PHD
• Nick Tanner DDS, PLLC
• Epiphany Lototele Nick, MD

• Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.