Individual
MRS. AMY SUZANNE FICKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
763 NW ADWICK DRIVE, BEAVERTON, OR 97006-9207
(317) 716-8197
Mailing address
763 NW ADWICK DRIVE, BEAVERTON, OR 97006-9207
(317) 716-8197
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930338LPN
OR
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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