Healthcare Provider Details

I. General information

NPI: 1366747636
Provider Name (Legal Business Name): NICOLE MARIE FALK LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE MARIE ALBANO LMFT

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 SW GRIFFITH DR STE 239
BEAVERTON OR
97005-4649
US

IV. Provider business mailing address

1110 SE ALDER ST STE 301
PORTLAND OR
97214-2400
US

V. Phone/Fax

Practice location:
  • Phone: 909-284-4950
  • Fax: 909-285-0564
Mailing address:
  • Phone: 909-285-4950
  • Fax: 909-285-0564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT78339
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT1620
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60694146
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: