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General NPI Number Information
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NPI Number | 1093640120
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Entity Type | Organization
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Legal Business Name | NICOLE BROWN PROF CORP
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 8311 SE 13TH AVE UNIT B2
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City | PORTLAND
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State | OR
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Zip | 97202-7170
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Country | US
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Telephone | 971-266-3191
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Fax |
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Provider Business Mailing Address
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Address Line | 8311 SE 13TH AVE UNIT B2
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City | PORTLAND
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State | OR
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Zip | 97202-7170
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE BROWN
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Credential |
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Telephone | 315-591-5399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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