Individual
NICOLE LOUISE CULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
3737 PORTLAND RD NE, SALEM, OR 97301-0311
(503) 390-2600
Mailing address
48 EAGLE CREST DR APT 5C, LAKE OSWEGO, OR 97035-1068
(520) 400-6798
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930903773
—
OR
Enumeration date
05/12/2010
Last updated
06/10/2010
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