Individual
JENNIFER SUE HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
30 NE MLK BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
(503) 232-3854
Mailing address
30 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
(503) 232-3854
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200741420RN
OR
Other
Enumeration date
05/29/2017
Last updated
07/16/2020
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