Individual
CHARLEE FAY VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
945 NE 165TH AVE, PORTLAND, OR 97230-6148
(503) 408-8100
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
12/18/2024
Last updated
04/30/2025
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