Healthcare Provider Details

I. General information

NPI: 1386347193
Provider Name (Legal Business Name): NICHOLAS ARTHUR DAWSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19875 SW 65TH AVE STE 100
TUALATIN OR
97062-8353
US

IV. Provider business mailing address

19875 SW 65TH AVE
TUALATIN OR
97062-8353
US

V. Phone/Fax

Practice location:
  • Phone: 503-692-7785
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD228888
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: