Provider Demographics
NPI:1679012603
Name:HINSLEY, NICOLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:HINSLEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 SW 11TH ST
Mailing Address - Street 2:STE. 620
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201
Mailing Address - Country:US
Mailing Address - Phone:503-894-1539
Mailing Address - Fax:503-210-1453
Practice Address - Street 1:17020 SW UPPER BOONES FERRY RD,
Practice Address - Street 2:STE. 201
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97248
Practice Address - Country:US
Practice Address - Phone:503-894-1539
Practice Address - Fax:503-210-1453
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist