Individual
NICOLE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N DIXON ST, PORTLAND, OR 97227-1804
(503) 916-6370
Mailing address
501 N DIXON ST, PORTLAND, OR 97227-1804
(503) 916-6370
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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