Individual
NICOLE JENE FENNIMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10101 SE MAIN ST STE 3001, PORTLAND, OR 97216-2458
(503) 261-4423
(503) 261-4424
Mailing address
10101 SE MAIN ST STE 3001, PORTLAND, OR 97216-2458
(503) 261-4423
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD205498
OR
Other
Enumeration date
03/26/2019
Last updated
10/23/2023
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