Individual
CANDACE TICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16463 BOONES FERRY RD STE 300, LAKE OSWEGO, OR 97035-4376
(503) 658-9351
(541) 708-5934
Mailing address
16463 BOONES FERRY RD STE 300, LAKE OSWEGO, OR 97035-4376
(503) 658-9351
(541) 708-5934
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10042487
OR
363LF0000X
Family Nurse Practitioner
APR11020311
FL
363LF0000X
Family Nurse Practitioner
Primary
C-APN.0004329-C-NP
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/24/2020
Last updated
02/11/2026
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