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Individual

KRISTOPHER NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CO

Contact information

Practice address
1627 NE BROADWAY, PORTLAND, OR 97232-1425
(503) 287-0459
(503) 281-9252
Mailing address
1627 NE BROADWAY, PORTLAND, OR 97232-1425
(503) 287-0459
(503) 281-9252

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary

Other

Enumeration date
08/17/2010
Last updated
08/17/2010
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