Individual
NICOLE L BISHOP-PERDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, 1ST FLOOR, PORTLAND, OR 97225-6603
(503) 216-2906
(503) 216-4114
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD26801
OR
208M00000X
Hospitalist Physician
Primary
MD26801
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026493
—
OR
01
—
P00479386
RR MEDICARE
—
Enumeration date
08/29/2006
Last updated
03/30/2017
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