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1821134016
LISA MARIE NICHOLS
PORTLAND, OR
NPI
1821134016
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-01-29
Last Update Date
2007-07-08
Business Address
Mrs. LISA MARIE NICHOLS QMHA
412 SW 12TH AVE
PORTLAND, OR 97205-2329
Phone number: 503-552-5105
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Mailing Address
Mrs. LISA MARIE NICHOLS QMHA
7028 N MOBILE AVE
PORTLAND, OR 97217-5744
Phone number: 503-552-5105
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