Individual
MR. JEFFREY ROBERT NIKOLAISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
439 SOUTHEAST 223RD AVENUE, GRESHAM, OR 97030
(503) 667-0394
Mailing address
439 SOUTHEAST 223RD AVENUE, GRESHAM, OR 97030
(503) 667-0394
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0011289
OR
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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