Provider Demographics
NPI:1114335619
Name:NOHNER, NICOLE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:NOHNER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9125 SW BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4828
Mailing Address - Country:US
Mailing Address - Phone:971-336-9272
Mailing Address - Fax:
Practice Address - Street 1:9125 SW BOONES FERRY RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4828
Practice Address - Country:US
Practice Address - Phone:971-336-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR292591225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist