Individual
NICOLE SAZONOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8329 SW BEAVERTON HILLSDALE HWY, PORTLAND, OR 97225-2215
(503) 414-5160
Mailing address
8329 SW BEAVERTON HILLSDALE HWY, PORTLAND, OR 97225-2215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA217770
OR
363A00000X
Physician Assistant
Primary
PA217770
OR
Other
Enumeration date
08/29/2022
Last updated
12/13/2023
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