Individual
NITA JENNIE LIKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7110 SW FIR LOOP STE 160, PORTLAND, OR 97223-8031
(971) 900-7126
Mailing address
1221 NE 51ST AVE APT 309, HILLSBORO, OR 97124-6192
(503) 718-4585
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/14/2020
Last updated
02/14/2020
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