Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | MD153296 | OR |
NPI | 1306801386 |
---|---|
Provider Name | Lindsey E. Nicol |
First Address | Portland, OR 97239-2901 |
Second Address | Portland, OR 97239-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/05/2013 |