Individual
THEODORE THORSTEN NYQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2163 NW 2ND STREET, MCMINNVILLE, OR 97128-9108
(503) 472-4197
(503) 434-2886
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18091
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056221
—
OR
Enumeration date
09/15/2006
Last updated
05/06/2025
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