IndividualActive
Shannon Nichols, RN
NPI 1306442504 · General Practice Registered Nurse · Portland, OR
Provider details
- NPI number
- 1306442504
- Entity type
- Individual
- Primary specialty
- General Practice Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- 201041810RN (OR)
Specialties & taxonomies
Nursing Service Providers
Practice location
4400 Ne Halsey St
Portland, OR 97213-1545
Phone: (503) 513-1300
Fax: (503) 513-1310
Approximate (ZIP-level) locationGet directions
Mailing address
4400 Ne Halsey St
Portland, OR 97213-1545
Registry dates
- Enumerated
- 2020-12-11
- Last updated
- 2024-07-18
- Certified
- 2024-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.