IndividualActive
Nicole Clark
NPI 1023513637 · Counselor · Portland, OR
Nicole Clark is a Counselor provider in Portland, OR (NPI 1023513637).
Provider details
- NPI number
- 1023513637
- Entity type
- Individual
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Practice location
3650 Ne Mallory Ave Apt 309
Portland, OR 97212-3086
Phone: (971) 331-0422
Street-level locationGet directions
Mailing address
3650 Ne Mallory Ave Apt 309
Portland, OR 97212-3086
Registry dates
- Enumerated
- 2018-03-26
- Last updated
- 2018-12-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.