Individual
NICOLE C TABBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
25030 SW PARKWAY AVE STE 200, WILSONVILLE, OR 97070-9816
(971) 434-0080
(503) 946-3891
Mailing address
25030 SW PARKWAY AVE STE 200, WILSONVILLE, OR 97070-9816
(971) 434-0080
(503) 946-3891
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
201906846NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
201906846NP-PP
OK
Other
Enumeration date
08/07/2019
Last updated
02/11/2025
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