Individual
KIMBERLY RENEE RICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4400 NE HALSEY ST STE 200, PORTLAND, OR 97213-1545
(503) 215-6556
Mailing address
4400 NE HALSEY ST STE 200, PORTLAND, OR 97213-1545
(503) 215-6556
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10006273
OR
Other
Enumeration date
04/20/2023
Last updated
02/24/2025
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