Individual
JO ANNE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14279 GLEN OAK RD, OREGON CITY, OR 97045-8008
(503) 657-7629
(503) 557-8651
Mailing address
19069 S PIONEER CROSSING LN, ESTACADA, OR 97023-9687
(503) 631-7087
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD14362
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128553
—
OR
01
—
3323000
BCBS
OR
Enumeration date
06/04/2006
Last updated
12/11/2012
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