Individual
MS. TEVER D NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
3701 SE MILWAUKIE AVE STE E, PORTLAND, OR 97202-3835
(503) 784-2377
Mailing address
3701 SE MILWAUKIE AVE STE E, PORTLAND, OR 97202-3835
(503) 784-2377
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3163
OR
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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