SearchOregon175T00000X

Nicole Jackson

NPI 1063390870 · on the registry since 2025

Practice

Address
8355 N Interstate Ave
Portland, OR 97217
Phone
(503) 568-1408

Registry record

Primary taxonomy
175T00000X
175T00000X
Also registered as
251S00000X
101YA0400X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-10-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon