Lillian Ruth Nickerson, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201607315RN Issued in OR

Practice address

832 NE 162ND Ave
Portland, OR 97230-5765

Phone

(503) 262-0145

NPI assigned

Feb 8, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1982142147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305765",
            "telephone_number": "503-262-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "LILLIAN",
        "middle_name": "RUTH",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201607315RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Nickel, MSW, LICSW
• Jereme Dawn Nickell, OT
• Joshua Phillip Nickelsen
• Jacob Nickerson, LMT
• Joshua Paul Nickerson, M.D.
• Nathan Jaylen Nickerson
• Tever D Nickerson, L.P.C.
• Suzanne Jensen Nicks, SLP
• Lindsey E. Nicol, M.D.
• Lauren Nicola-Ducey, M.D.

• Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.