IndividualActive
Octavia Nightingale
NPI 1225639826 · Pediatric Skilled Nursing Facility · Lake Oswego, OR
Provider details
- NPI number
- 1225639826
- Entity type
- Individual
- Primary specialty
- Pediatric Skilled Nursing FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 513068 (OR)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
4190 Collins Way
Lake Oswego, OR 97035-3448
Phone: (503) 636-0966
Fax: (503) 675-3552
Approximate (ZIP-level) locationGet directions
Mailing address
4190 Collins Way
Lake Oswego, OR 97035-3448
Registry dates
- Enumerated
- 2020-11-02
- Last updated
- 2020-11-02
- Certified
- 2020-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.