MEDICARE: VICKI LINN QUICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BN1400X	Nursing Facility Supplies (DME)

General Provider Information

NPI Number	:	1447037296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI LINN QUICK

Provider Business Mailing Address
First Line	:	8830 SW OAK LN
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-7285
Country	:	US
Telephone Number	:	503-997-2432
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 SW OAK LN
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-7285
Country	:	US
Telephone Number	:	503-997-2432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2023
Last Update Date	:	09/13/2023

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Directions to “ VICKI LINN QUICK ” Practice Location

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