Individual
NICKOLAS REGUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15-06-15
OR
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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