Individual
JUDY VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20545 SW PARKER CT, BEAVERTON, OR 97078-1030
(503) 719-9515
Mailing address
20545 SW PARKER CT, BEAVERTON, OR 97078-1030
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200941059RN
OR
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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