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Individual

MICHAEL J NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3710 SW US VETERANS HOSPITAL RD, P5PATH, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
7641 SW HOOD AVE, PORTLAND, OR 97219-2933
(503) 246-1657

Taxonomy

Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
96-109
NM
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
96-109
NM

Other

Enumeration date
09/25/2006
Last updated
08/29/2015
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