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General NPI Number Information
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NPI Number | 1528992310
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Entity Type | Individual
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Provider Name | NICHOLAS PAGAN SLP
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Gender | Male
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 1610 SE GLENWOOD ST
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City | PORTLAND
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State | OR
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Zip | 97202-5615
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Country | US
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Telephone | 971-217-2059
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 SW BRIGGS CT
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City | BEAVERTON
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State | OR
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Zip | 97005-1100
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Country | US
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Telephone | 971-217-2059
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18803
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License Number State | OR
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