Provider Demographics
NPI:1386538833
Name:HALFMAN, NICOLE (LCPO)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HALFMAN
Suffix:
Gender:F
Credentials:LCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4586 BLUE SKY CT SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-6025
Mailing Address - Country:US
Mailing Address - Phone:503-510-4103
Mailing Address - Fax:
Practice Address - Street 1:8614 E MILL PLAIN BLVD STE 110
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2058
Practice Address - Country:US
Practice Address - Phone:360-213-2088
Practice Address - Fax:360-213-0311
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOI61494436222Z00000X
WAPS61620699224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist