Provider Demographics
NPI:1346440070
Name:NIELSON, ERIC F (MA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:F
Last Name:NIELSON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1541
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-1541
Mailing Address - Country:US
Mailing Address - Phone:503-939-9024
Mailing Address - Fax:
Practice Address - Street 1:2100 SE LAKE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7759
Practice Address - Country:US
Practice Address - Phone:503-939-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist