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General NPI Number Information
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NPI Number | 1366747636
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Entity Type | Individual
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Provider Name | NICOLE MARIE FALK LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 1110 SE ALDER ST STE 301
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City | PORTLAND
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State | OR
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Zip | 97214-2400
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Country | US
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Telephone | 909-284-4950
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Fax | 909-285-0564
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Provider Business Mailing Address
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Address Line | 1110 SE ALDER ST STE 301
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City | PORTLAND
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State | OR
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Zip | 97214-2400
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Country | US
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Telephone | 909-285-4950
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Fax | 909-285-0564
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF60694146
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT78339
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T1620
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License Number State | OR
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