Provider Demographics
NPI:1699798199
Name:CIRINO, NICOLE HARRINGTON (MD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:HARRINGTON
Last Name:CIRINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:L587 STUDENT HEALTH SERVICE
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-494-8665
Mailing Address - Fax:503-494-9099
Practice Address - Street 1:6651 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2351
Practice Address - Country:US
Practice Address - Phone:832-826-7376
Practice Address - Fax:832-825-7948
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU267022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
054123029OtherBLUE CROSS
J930728OtherPACIFIC SOURCE