MS. LAURA MARIE WICKLINE PMHNP NPI 1205090586

NPI Information

NPI: 1205090586
Provider Name: MS. LAURA MARIE WICKLINE, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
1132 SW 13TH AVE
PORTLAND, OR
ZIP 97205
Phone: (503) 484-3341
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MS. Laura Marie Wickline, PMHNP is a psychiatric/mental health nurse practitioner in Portland, OR. MS. Laura Marie Wickline, PMHNP NPI is 1205090586. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1132 SW 13TH AVE
PORTLAND, OR
ZIP 97205-703
Phone: (503) 484-3341

The enumeration date for this NPI number is 7/15/2008 and was last updated on 2/8/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0808X	Registered Nurse	Psychiatric/Mental Health	200442418RN	OREGON	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	200950021NP	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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