Individual
NICOLE MUTNANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
12725 SW MILLIKAN WAY STE 300, BEAVERTON, OR 97005-1687
(971) 319-1592
Mailing address
12725 SW MILLIKAN WAY STE 300, BEAVERTON, OR 97005-1687
(971) 319-1592
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP019347
PA
Other
Enumeration date
11/01/2016
Last updated
03/09/2026
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