Individual
NICHOLAS DEFELICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(800) 813-2000
Mailing address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD224667
OR
Other
Enumeration date
04/04/2021
Last updated
09/13/2025
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