Individual
NIKOBI PETRONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11073 SE MAIN ST, MILWAUKIE, OR 97222-7645
(541) 214-7680
Mailing address
11073 SE MAIN ST, MILWAUKIE, OR 97222-7645
(541) 214-7680
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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