Individual
DR. LUANNE NILSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 643-7565
Mailing address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00025684
WA
208000000X
Pediatrics Physician
Primary
MD15125
OR
Other
Enumeration date
08/24/2006
Last updated
07/13/2007
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