Individual
NICKIESHA MONICKS YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5316 NE 29TH AVE, PORTLAND, OR 97211-6242
(503) 405-2352
Mailing address
5316 NE 29TH AVE, PORTLAND, OR 97211-6242
(503) 405-2352
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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