Provider Demographics
NPI:1205471976
Name:LEFEBVRE, NICOLE J
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:J
Last Name:LEFEBVRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15805 27TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-6440
Mailing Address - Country:US
Mailing Address - Phone:425-409-4006
Mailing Address - Fax:
Practice Address - Street 1:9600 COLLEGE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3514
Practice Address - Country:US
Practice Address - Phone:206-934-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-16
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician