Individual
MICHELE NETH DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
12123 SW 69TH AVE, TIGARD, OR 97223-8514
(971) 708-7600
(971) 371-5230
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00105798
WA
363LF0000X
Family Nurse Practitioner
Primary
MD0118364
OR
363LW0102X
Women's Health Nurse Practitioner
AP30003195
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500018475
MEDICARE RR
WA
05
—
9609454
—
WA
Enumeration date
01/20/2006
Last updated
07/17/2023
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