Individual
DR. NICOLE CASTONGUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2177 NW IRVING ST APT 2, PORTLAND, OR 97210-3386
(267) 847-8209
Mailing address
2177 NW IRVING ST APT 2, PORTLAND, OR 97210-3386
(267) 847-8209
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
60001122
WA
208000000X
Pediatrics Physician
Primary
MD172735
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006080
—
WA
05
—
500687986
—
OR
Enumeration date
01/28/2008
Last updated
09/11/2019
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