Individual
MIKI K NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, OHSU, PORTLAND, OR 97239
(503) 494-8211
Mailing address
4405 VANDEVER AVE, SAN DIEGO, CA 92120-3315
(617) 270-4825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A125672
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2009
Last updated
12/02/2021
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