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1174127476
JESSICA ANTOINETTE NICHOLAS
PORTLAND, OR
NPI
1174127476
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-11-27
Last Update Date
2020-11-27
Business Address
JESSICA ANTOINETTE NICHOLAS
5725 NE PRESCOTT ST
PORTLAND, OR 97218-2275
Phone number: 503-548-8085
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Mailing Address
JESSICA ANTOINETTE NICHOLAS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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