Provider Demographics
NPI:1588988869
Name:NASSHAHN, NYKOLE MARIE (BS)
Entity type:Individual
Prefix:
First Name:NYKOLE
Middle Name:MARIE
Last Name:NASSHAHN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:NYKI
Other - Middle Name:
Other - Last Name:NASSHAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:31637 SE DODGE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-8964
Mailing Address - Country:US
Mailing Address - Phone:541-510-0592
Mailing Address - Fax:
Practice Address - Street 1:31637 SE DODGE PARK BLVD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-8964
Practice Address - Country:US
Practice Address - Phone:541-510-0592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health