Provider Demographics
NPI:1457681223
Name:SEYMANSKI, NICHOLE M (PSYD)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:M
Last Name:SEYMANSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 MARVIN RD NE STE C
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-3878
Mailing Address - Country:US
Mailing Address - Phone:253-590-5192
Mailing Address - Fax:
Practice Address - Street 1:677 WOODLAND SQUARE LOOP SE STE C-2
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98503-1000
Practice Address - Country:US
Practice Address - Phone:253-590-5192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60092515103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical