Most Relevant Information
Provider Data
| NPI Number: | 1003224205 |
| Provider Name: | NELLIE CICHON CADC 1 |
| Entity Type: | Individual |
| Taxonomy Code: | 103TP2701X |
| Specialty: | Psychologist |
| License Number: | 14-04-02 |
Most Important Dates
| Enumeration Date: | 07/31/2014 |
| Last Updated: | 07/31/2014 |
Provider Practice Location
8202 N DENVER AVE
PORTLAND
OR
972176624
Practice Location Phone/Fax
| Phone: | 5032853200 |
| Fax: | 5032456263 |
Provider Mailing Location
10101 SW BARBUR BLVD
PORTLAND
OR
972195915
Provider Mailing Phone/Fax
| Phone: | 5032456262 |
| Fax: | 5032456263 |