Individual
MRS. NELLIE CICHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC 1
Contact information
Practice address
8202 N DENVER AVE, PORTLAND, OR 97217-6624
(503) 285-3200
(503) 245-6263
Mailing address
10101 SW BARBUR BLVD, PORTLAND, OR 97219-5915
(503) 245-6262
(503) 245-6263
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
14-04-02
OR
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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