Individual provider · Type 1 NPI

Michael Joseph Dickens Ii

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1194571380 Active

Practice location

Legacy Good Samaritan Medical Center- Gme 1015 NW 22nd
Portland, OR 97210

Fax (503) 413-6892

Mailing address

Legacy Good Samaritan Medical Center Gme 1015 NW 22nd
Portland, OR 97210

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1194571380

Michael Joseph Dickens Ii's National Provider Identifier is 1194571380, issued on Apr 29, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Apr 30, 2026.