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1760954150
BRENDA LYNN GROSSNICKLE
PORTLAND, OR
NPI
1760954150
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
364S00000X Clinical Nurse Specialist
(Licence: OR 201808009CNS-PP)
Enumeration Date
2018-12-22
Last Update Date
2018-12-22
Business Address
BRENDA LYNN GROSSNICKLE CNS
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239-2964
Phone number: 503-220-8262
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Mailing Address
BRENDA LYNN GROSSNICKLE CNS
9410 SE NICHOLAS DR
HAPPY VALLEY, OR 97086-7350
Phone number:
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