Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1669 | OR |
N | 175F00000X | Naturopath | NT60051160 | WA |
NPI | 1093960080 |
---|---|
Provider Name | Dr. Melinda Nickels |
First Address | Astoria, OR 97103-6338 |
Second Address | Astoria, OR 97103-6338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 14/10/2021 |