Individual
NICOLE MK BEHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD191204
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD191204
OREGON MEDICAL LICENSE
OR
Enumeration date
09/01/2007
Last updated
02/03/2022
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