Individual
NICHOLAS ANDREW WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-3076
(360) 431-4408
Mailing address
3455 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-3076
(360) 431-4408
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201900742RN
OR
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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