Individual
MICHAEL DAVID NOMINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW,LCSW
Contact information
Practice address
11740 SW 68TH PKWY STE 200, PORTLAND, OR 97223-9058
(425) 640-7009
Mailing address
PO BOX 820128, PORTLAND, OR 97282-1128
(503) 816-8550
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2579
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L2579
OREGON BOARD OF LICENSED SOCIAL WORKERS
OR
Enumeration date
07/27/2006
Last updated
06/30/2023
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