Individual
MR. NICHOLAS GEORGE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2191 MARION ST, NORTH BEND, OR 97459-2314
(541) 756-8022
Mailing address
2191 MARION ST, NORTH BEND, OR 97459-2314
(541) 756-8022
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
092003400RN
OR
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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