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1801211073
NICKEY R FOSSETT
EUGENE, OR
NPI
1801211073
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: OR T1020)
Enumeration Date
2014-02-25
Last Update Date
2016-04-19
Business Address
-- NICKEY R FOSSETT LMFT
1017 ARTHUR ST
EUGENE, OR 97402
Phone number: 541-636-6180
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Mailing Address
-- NICKEY R FOSSETT LMFT
2045 SE HAWTHORNE BLVD
PORTLAND, OR 97214-3819
Phone number: 541-636-6180
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