Individual
DANIEL MCNICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1507 NE 122ND AVE, PORTLAND, OR 97230-1911
(503) 258-4599
Mailing address
1507 NE 122ND AVE, PORTLAND, OR 97230-1911
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
Other
Enumeration date
01/13/2014
Last updated
01/29/2022
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