Individual
SHANNON ALEXIS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5171
(503) 494-4631
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5171
(503) 494-4631
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
31016
OR
Other
Enumeration date
08/31/2021
Last updated
03/10/2022
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