Individual
NICOLE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 SW YAMHILL ST STE 301, PORTLAND, OR 97205-2110
(503) 226-7079
Mailing address
1221 SW YAMHILL ST STE 301, PORTLAND, OR 97205-2110
(503) 226-7079
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A15799
OR
104100000X
Social Worker
—
—
Other
Enumeration date
10/01/2024
Last updated
03/11/2025
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