Lillian Ruth Nickerson, R.N.
Registered Nurse in Portland, OR. Individual provider (NPI-1).
NPI number1982142147
StatusActive
Last updated in NPPESFeb 8, 2017
Details
- NPI
- 1982142147
- Entity type
- Individual (NPI-1)
- Name
- Lillian Ruth Nickerson
- Credential
- R.N.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 8, 2017
- Last updated
- Feb 8, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 201607315RN | OR | Yes |
Practice location
832 Ne 162nd AvePortland, OR 97230-5765
Phone 503-262-0145
Mailing address
722 Ne 162nd AvePortland, OR 97230-5760
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