NPI 1184407629

Nicole Dickerson

Practitioner Peer Specialist Lincoln City, OR

Practice location

Address: 1345 NW 15th St, Lincoln City, OR 97367-3327
Phone: (541) 574-9570
Fax: (541) 574-8857
Mailing address: PO Box 1538, Newport, OR 97365-0115

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence 22-CRM-1313 (OR)

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Registry record

NPI: 1184407629
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Aug 2023
Record last updated: 17 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.