Individual
SABRINA R HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
30 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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