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1770612533
NICOLE JENNYS MEDINA
TIGARD, OR
NPI
1770612533
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-03-05
Last Update Date
2007-07-08
Business Address
-- NICOLE JENNYS MEDINA none
12450 SW FISCHER RD UNIT 225
TIGARD, OR 97224-2378
Phone number: 503-516-9172
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Mailing Address
-- NICOLE JENNYS MEDINA none
12450 SW FISCHER RD UNIT 225
TIGARD, OR 97224-2378
Phone number: 503-516-9172
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