Provider Demographics
NPI:1447037296
Name:QUICK, VICKI LINN
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:LINN
Last Name:QUICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 SW OAK LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-7285
Mailing Address - Country:US
Mailing Address - Phone:503-997-2432
Mailing Address - Fax:
Practice Address - Street 1:8830 SW OAK LN
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-7285
Practice Address - Country:US
Practice Address - Phone:503-997-2432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies