Individual
NICHOLAS CALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10123 SE MARKET, PORTLAND, OR 97216-2532
(503) 257-6132
(503) 251-6136
Mailing address
PO BOX 2097, PORTLAND, OR 97208
(503) 251-6132
(503) 251-6136
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD13143
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003830020
REGENCE BCBS
OR
05
—
148189
—
OR
05
—
8421919
—
WA
Enumeration date
05/28/2006
Last updated
12/04/2007
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