Individual
JENNIFER ELIZABETH NISLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4531 SE BELMONT ST STE 117, PORTLAND, OR 97215-1675
(971) 361-8303
Mailing address
1721 SE TACOMA ST APT 303, PORTLAND, OR 97202-6775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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