Individual
NICOLAS RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12121 E BURNSIDE ST, PORTLAND, OR 97216-3737
(971) 361-7700
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
202103720RN
OR
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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