Individual
NICHOLE JANTETTE WELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 MCLOUGHLIN BLVD STE 68, OREGON CITY, OR 97045-1072
(503) 387-8000
Mailing address
188 FINNEYS AVE, MOLALLA, OR 97038-9798
(503) 504-2546
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
118674
OR
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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