Individual
COURTNEY NALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3303 S BOND AVE FL 9, PORTLAND, OR 97239-4501
(503) 494-8573
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-8573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
018496
ME
207Q00000X
Family Medicine Physician
4301115461
MI
207Q00000X
Family Medicine Physician
Primary
MD15592
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500637335
—
OR
Enumeration date
07/12/2007
Last updated
10/29/2020
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