Individual
JESSICA NICOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 NE HALSEY ST BLDG 2, PORTLAND, OR 97213-1545
(503) 893-7146
Mailing address
4400 NE HALSEY ST BLDG 2, PORTLAND, OR 97213-1545
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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