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General NPI Number Information
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NPI Number | 1215007596
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Entity Type | Individual
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Provider Name | HILLARY A. NICHOLSON MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 10180 SE SUNNYSIDE RD
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City | PORTLAND
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State | OR
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Zip | 97219-7113
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Country | US
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Telephone | 971-334-5098
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NE MULTNOMAH ST STE 100
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City | PORTLAND
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State | OR
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Zip | 97232-2031
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Country | US
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Telephone | 8-813-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD26529
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License Number State | OR
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