Mary Lee Nichols Phd Llc
Psychologist · Portland, OR
At a glance
1133 Nw 21St Ave, Portland, OR 97209-1513
NPPES record updated Sep 6, 2018. Public records can lag behind changes at a practice.
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Practice location
1133 Nw 21St AvePortland, OR 97209-1513
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Psychologist
- Taxonomy code
- 103T00000X
- Enumeration date
- Sep 6, 2018
- Record updated
- Sep 6, 2018
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Psychologist
103T00000X · Primary
License reported: 949 OR
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
1133 Nw 21St AvePortland, OR 97209-1513
- Phone
- (503) 277-3868
- Fax
- (503) 650-1892
Mailing address
1133 NW 21ST AVEPORTLAND, OR 972091513
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