Individual
NICOLE ELIZABETH TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
631 ELM ST SW STE 200&205, ALBANY, OR 97321-1952
(541) 812-5020
Mailing address
PO BOX 2792, CORVALLIS, OR 97339-2792
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO211584
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2018
Last updated
08/12/2024
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