Individual
MS. BRENDA JOY NUCKTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
0270 SW PALATINE HILL RD, PORTLAND, OR 97219-6576
(503) 236-4940
Mailing address
0270 SW PALATINE HILL RD, PORTLAND, OR 97219-6576
(503) 236-4940
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13525
OR
Other
Enumeration date
08/05/2011
Last updated
08/05/2011
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