Search › Oregon › 104100000X
Nicky Callicotte
NPI 1205084845 · on the registry since 2008 · sole proprietor
Practice
- Address
- 36860 Industrial Way
Sandy, OR 97055 - Phone
- (503) 826-0206
- Organisation at this address
- Legacy Clinics Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 10
Additional practice sites
- 847 Ne 19th Ave, Portland, OR
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 171M00000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-06-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon